[Comparison of anti-HBV vaccine efficacy given intradermally and intramuscularly in hemodialysis patients]

Abstract

Patients chronically hemodialysed are recognised as a group of especially high risk for viral hepatitis B (HBV) infection. Moreover, their hyporesponsiveness to vaccination is widely known. So establishment of highly effective vaccination protocol is indispensable. We are presenting 5 year prospective observations of results of hemodialysis patients anti-HBV vaccination. 36 patients were vaccinated intramuscularly (among them 30 were revaccinated intradermally) and 40 patients--only intradermally. We revealed that seroprotective level of anti-HBs antibodies should be at least 100 IU/ml. We disclosed, that intradermal anti-HBV vaccination--compared to intramuscular--was significantly more effective (77.5%--and including answer in the second vaccination cycle 85.0%--vs 38.9%) and, moreover, less amount of vaccine could be used (28.2 micrograms--and for patients answering barely in the second vaccination cycle 53.7 micrograms--vs 123 micrograms). However, after intradermal vaccination seroprotective antibodies level falls faster and should be checked every 3 months. Patients answering efficiently to vaccination--comparing to answering inefficiently--have significantly higher albumin level and are younger. Moreover, higher dialysis dose favors the successful long-time answer to vaccination.