HEPATITIS B VACCINE IMMUNOGENICITY IN A KENYAN HEMODIALYSIS UNIT: A RETROSPECTIVE ANALYSIS OF SEROPROTECTION GAPS

 

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HEPATITIS B VACCINE IMMUNOGENICITY IN A KENYAN HEMODIALYSIS UNIT: A RETROSPECTIVE ANALYSIS OF SEROPROTECTION GAPS

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Kevin
Nguring'a
Ahmed Twahir atwahir296@gmail.com Parklands Kidney center Nephrology Nairobi Kenya -
Seth McLigeyo mcligeyo@yahoo.com University of Nairobi Nephrology Nairobi Kenya -
Wambugu Maranga marangawambugu@gmail.com Kenyatta National Hospital Nephrology Nairobi Kenya -
Abdullahi Hadi abdallahaadi@gmail.com University of Pretoria Gastroenterology Pretoria South Africa -
Kevin Nguring'a kevinwitkins@yahoo.com Parklands Kidney center Nephrology Nairobi Kenya *
 
 
 
 
 
 
 
 
 
 
Patients with end-stage kidney disease (ESKD) on maintenance haemodialysis (HD) are at an increased risk of acquiring hepatitis B virus (HBV) infection. Active hepatitis B virus (HBV) immunization in these patients is therefore recommended. Hepatitis B immunological response rate in patients on maintenance HD is variable but generally lower than that of healthy individuals.

The aim of this study was to evaluate immunological response to hepatitis B vaccination and correlate response to various clinical and biomedical factor in patients on maintenance HD.

This was a retrospective cross sectional observational study conducted between 1st January 2023 to 1st January 2024 at Parklands Kidney Center, renal unit, Nairobi. The study population was adults aged 18 years and above who were on maintenance haemodialysis. They should have received at least 40 μg double dose high frequency of HBV vaccine administered intramuscularly in the deltoid region at 0, 1, 2 and 6 months. The patients' immunological response to vaccination was determined by the measured hepatitis B surface antibody (HBsAb) titres done between 6 to 12 weeks after the last injection.

Ninety-two patients (78 %) mounted a response with HBsAb ≥ 10 mIU/mL and thus were considered as adequate responders. Sixty-four (54 %) patients mounted an excellent response with HBsAb ≥ 100 mIU/ml. Twenty-six patients (22 %) were non-responders HBsAb ≤ 10 mIU/mL. A young age ≤ 40 years (P < 0.031), diabetes mellitus (P < 0.009), duration of dialysis ≤ 1 year (P < 0.009), and urea reduction ratio ≥ 65 % (< 0.001) predicted a positive immunological response to HB vaccination. Gender, haemoglobin level, serum albumin, serum ferritin, parathyroid hormone level, C reactive protein and vitamin D had no effect on the immunological response to HB vaccination. In addition, out of the 118 (100 %) patients on maintenance HD all were HBsAg negative, of those tested for HbcAb 25 (21.2 %) were positive an indication of ongoing occult infection or a resolved one.
A 78 % immunological response rate to HB vaccination was observed in this study cohort. Young age, diabetes mellitus, duration of dialysis and a urea reduction ratio predicted a favourable response to HB vaccine in patients on maintenance HD.
Kewords