Ahsan Mobin, Fawed Qureshi, Muhammad Umar Khan, Rakhshinda Jabeen.
Vaccinated hemodialysis patients; the status of immunity against the hepatitis b virus, at a tertiary care hospital.
Professional Med J Jan ;23(04):396-400.

Objectives: Determine the status of immunity against the hepatitis B virus among vaccinated hemodialysis patients at a tertiary care hospital. Study Design: Cross sectional study. Place and Duration of Study: All medical wards of Civil Hospital and Ojha campus, Dow University of Health Sciences, Karachi, Pakistan from May 2013 to January 2015. Methodology: Patients with chronic kidney disease on hemodialysis attending out-patient department were enrolled. Patients with either gender and aged 18-70 years, who give consent for participation, who are on HD for more than 9 months with a proven diagnosis of ESRD who have received a complete course of 4 doses of hepatitis B vaccination atleast 2 months back were included in this study. Non-consenting patients, present/past history of viral hepatitis, patients who were hepatitis B surface antigen (HBsAg) positive, patients on immunosuppressive agents, pregnant patients were excluded from this study. Results: Out of the 103 patients, 69 (67%) males and 34 (33%) females with mean age of study population was 51.1 ± 14.3 years (17 to 70 years), mean duration post vaccination was 7.6 ± 0.9 months (6 to 9 months), mean anti HBs antibody level was 184.6 ± 293.4 (level rang 0 to 1000) and mean hemodialysis duration was 26.4 ± 12 months (10 to 50 month). Out of 37 non-responders 28 (75.7%) had twice weekly schedule of hemodialysis and 09 (24.3%) had thrice weekly schedule of hemodialysis, out of 19 weak responders 13 (68.4%) had twice weekly schedule of hemodialysis and 06 (31.6%) had thrice weekly schedule of hemodialysis and out of 47 high responders 29 (61.7%) had twice weekly schedule of hemodialysis and 18 (38.3%) had thrice weekly schedule of hemodialysis (p=0.395). Conclusion: Excellent response of HbsAg B vaccination for those patients, undergo dialysis procedure that is not associated with age, systemic inflammation or nutritional. Effective dialysis procedure associated with excellent response to the vaccine hepatitis B.

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