POBOLJŠAVA LI UČINKOVITIJA HEMODIJALIZA ODGOVOR NA CIJEPLJENJE PROTIV VIRUSA HEPATITISA B?

Summary. Patients on chronic haemodialysis (PCHD) elicit a weaker response to vaccination with recombinant hepatitis B virus vaccine. We conducted this study to demonstrate factors which could affect response to HBV vaccination. Subjects were 30 PCHD. All subjects were vaccinated with 4×40 μg recombinant HBV vaccine given i.m. at intervals 0, 1, 2, and 6 months. Subjects were divided into groups according to the level of antibody (HbsAb): nonresponders (<10 i.u./L), weak responders (10–100 i.u./L), and good responders (>100 i.u./L). A statistically significant difference was found between responders and nonresponders in the dialysis efficiency (Kt/V) (p=0.027). A multivariate analysis of variance unveiled a significant difference between the groups of nonresponders, weak and good responders in the Kt/V value (p=0.028), and the subject age (p=0.080). Positive correlation between HBsAb level and Kt/V (r=0.46; p=0.006), and negative correlations between HBsAb and: subject age (r=–0.40; p=0.026), existence of diabetes (r=–0.32; p=0.041), blood leukocyte number (r=–0.31; p=0.050), and body mass index (r=–0.42; p=0.011) were demonstrated. A multiple linear regression analysis demonstrated the most significant positive correlation between HBsAb level and the Kt/V values (p=0.002), and negative correlation between HBsAb level and the subject age (p=0.047). The HBV vaccination response was weaker in PCHD with inefficient dialysis and older age. Efficient haemodialysis most significantly improves the response to vaccination.