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Is hemodialysis a reason for unresponsiveness to hepatitis B vaccine? Hepatitis B
virus and dialysis therapy
#MMPMID25914776
Sit D
; Esen B
; Atay AE
; Kayaba?? H
World J Hepatol
2015[Apr]; 7
(5
): 761-8
PMID25914776
show ga
Impaired renal function is associated with a high risk of chronicity of hepatitis
B virus (HBV) infection. Patients on hemodialysis (HD) or peritoneal dialysis are
at an increased risk of viral transmission due to frequent necessity of blood
product transfer as well as use of contaminated dialysate or dialysis materials.
Additionally, health professionals may cause viral spread via contaminated hands
and carelessness against hygiene rules. The frequency of chronic HBV infection
may be as high as 80% in patients on renal replacement therapies. This is because
HBV vaccination is essential to eliminate chronic HBV infection. However,
response rates of HD patients to HBV vaccination vary between 10%-50%. Dialysis
adequacy and early vaccination before the onset of dialysis therapy seem to be
major determinants of high seroconversion rates. Older age, male gender, duration
of dialysis therapy and nutritional status are other well-known factors
associated with seroconversion rate. There are controversial reports regarding
the role of the presence of diabetes mellitus, HCV positivity, erythropoietin
resistance, hyperparathyroidism, and vitamin D inadequacy. The role of genetic
alteration in the functions or production of cytokines still needs to be
elucidated.
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