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  • Title: [Efficacy of prophylactic vaccination against Hepatitis B Virus infection viruses in hemodialyzed patients].
    Author: Urbanowicz W.
    Journal: Przegl Epidemiol; 2000; 54(3-4):343-50. PubMed ID: 11349597.
    Abstract:
    Dialysed patients constitute one of the most important risk groups for viral hepatitis infection. That is why different forms of prophylaxis are undertaken to diminish the number of infections. The aim of our study was to determine the efficacy of vaccination against HBV infection among dialysed patients who may be regarded as immunocompromised subjects. There were 104 patients in the dialysis programme enrolled to the study. The full serology of HBV infection was done at the beginning. We determined also anti-HCV status. 20 patients (19.2%) were HBsAg-positive. 53 patients HBsAg-negative and anti-HBs-negative were subjected to vaccination. Engerix-B was the vaccine used and the scheme was the following: 0, 1, 2 and 6 months with each dose doubled (40 mcg). The shortest time of observation was 4 months. Good response to HBV vaccine is achieved in those dialysed patients who had been infected in the past but lost anti-HBs (anti-HBc-positive). The vaccine works as a "reminder" in this group. Anti-HBc-negative patients respond rather poorly to HBV vaccine and that protection may be incomplete ("low responders"-maximal antibody level below 100 IU/l). In 8 vaccinated patients anti-HBc total negative with anti-HBs level below 10 IU/l (non-responders) we observed acute B hepatitis during or shortly after vaccination. These infections were mostly subclinical. We did not observe significant difference of age, sex and HCV infection between responders and non-responders.
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