Immunogenicity and influencing factors of hepatitis B vaccination based on different vaccination schedules among chronic kidney disease patients.
10.3760/cma.j.cn112338-20210807-00618
- Author:
Yong Liang FENG
1
;
Yu Jie HAN
1
;
Tian YAO
1
;
Jian Min WANG
2
;
Hong Ting LIU
3
;
Hong Ping GUO
4
;
Guo Wei CHAI
5
;
Li Ming LIU
2
;
Fu Zhen WANG
6
;
Su Ping WANG
1
Author Information
1. Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China.
2. Department of Nephrology, Linfen Central Hospital, Linfen 041000, China.
3. Department of Nephrology, Yuncheng Central Hospital, Yuncheng 044000, China.
4. Department of Nephrology, Linfen People's Hospital, Linfen 041081, China.
5. Department of Nephrology, Houma People's Hospital, Houma 043011, China.
6. Department of National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
- Publication Type:Randomized Controlled Trial
- MeSH:
Animals;
CHO Cells;
Cricetinae;
Cricetulus;
Follow-Up Studies;
Hepatitis B/prevention & control*;
Hepatitis B Antibodies;
Hepatitis B Surface Antigens;
Hepatitis B Vaccines;
Humans;
Immunization, Secondary;
Renal Insufficiency, Chronic;
Vaccination
- From:
Chinese Journal of Epidemiology
2022;43(2):241-247
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the immunogenicity and influencing factors of hepatitis B vaccination based on different vaccination schedules among chronic kidney disease (CKD) patients. Methods: CKD patients who participated in randomized controlled trials in four hospitals in Shanxi province and completed three doses of 20 µg vaccination (at months 0, 1 and 6) and four doses of 20 µg or 60 µg vaccination (at months 0, 1, 2, and 6) were surveyed from May 2019 to July 2020.According to the ratio of 1∶1∶1, 273 CKD patients were divided into 3 groups randomly. Quantification of the anti-hepatitis B surface antigen-antibody (anti-HBs) in serum samples was performed using chemiluminescent microparticle immunoassay at months 1 and 6 after the entire course of the vaccinations. The positive rate, high-level positive rate, geometric mean concentration (GMC) of anti-HBs, and the influencing factors were analyzed by χ2 tests, analysis of variance, unconditional logistic regression analysis. Results: A total of 273 CKD patitents were participants.The positive rates in the CKD patients with four doses of 20 µg vaccination (92.96%,66/71) or 60 µg vaccination (93.15%, 68/73) were higher than that in the CKD patients with three doses of 20 µg vaccination (81.69%, 58/71) at month one after the full course of the vaccinations (P<0.05). The GMCs of anti-HBs showed similar results (2 091.11 mIU/ml and 2 441.50 mIU/ml vs. 1 675.21 mIU/ml) (P<0.05). The positive rate was higher in the CKD patients with four doses of 60 µg vaccination (94.83%,55/58) than in those with three doses of 20 µg vaccination (78.79%,52/66) (P<0.05) at month six after the full course of the vaccinations. And the GMC of anti-HBs in the patients with four doses of 60 µg vaccination (824.28 mIU/ml) was significantly higher than those in the patients with 3 or 4 doses of 20 µg vaccination (639.74 mIU/ml and 755.53 mIU/ml) (P<0.05). After controlling the confounding factors, the positive rate in the CKD patients with four doses of 60 µg vaccination were 3.19 (95%CI: 1.02-9.96) and 5.32 (95%CI: 1.27-22.19) times higher than those in the patients with three doses of 20 µg vaccination at months 1 and 6 after the full course of the vaccinations, respectively. The positive rate in CKD patients without immune suppression or hormone therapy was 3.33 (95%CI: 1.26-8.80) and 4.78 (95%CI: 1.47-15.57) times higher than those in the patients with such therapy, respectively. Conclusions: Four doses of 20 µg or 60 µg hepatitis B vaccination could improve the immunogenicity in patients with CKD. And four doses of 60 µg vaccination might play a positive role in maintaining anti-HBs in this population. The immunogenicity in the CKD patients with immune suppression or hormone therapy was poor.
