Jump to content
RemedySpot.com

Meta-analysis: the impact of diabetes mellitus on the immunological response to hepatitis B virus vaccine in dialysis patients

Rate this topic


Guest guest

Recommended Posts

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2011.04589.x/abstract;jse\

ssionid=61F42763C7410A20D37A4AC8320593E2.d03t02?systemMessage=Due+to+scheduled+m\

aintenance%2C+access+to+Wiley+Online+Library+will+be+disrupted+on+Saturday%2C+5t\

h+Feb+between+10%3A00-12%3A00+GMT

Meta-analysis: the impact of diabetes mellitus on the immunological response to

hepatitis B virus vaccine in dialysis patients

F. Fabrizi1, V. Dixit2, P. 2, P. Messa1Article first published online: 1

FEB 2011

DOI: 10.1111/j.1365-2036.2011.04589.x

© 2011 Blackwell Publishing Ltd

Issue

Alimentary Pharmacology & Therapeutics

Early View (Articles online in advance of print)

Summary

Background  Patients on maintenance dialysis typically show a suboptimal

immune response to hepatitis B virus vaccine compared with the non-uraemic

population. A variety of inherited or acquired factors have been implicated in

this diminished response. It is well known that patients with diabetes mellitus

have a compromised immune system, and diabetic nephropathy is an important cause

of chronic kidney disease. However, the impact of diabetes mellitus on the

immune response to HBV vaccine in patients receiving long-term dialysis remains

unclear.

Aim  To evaluate the influence of diabetes mellitus on the immune response to

HBV vaccine in dialysis population by performing a systematic review of the

literature with a meta-analysis of clinical studies.

Methods  We used the random effects model of DerSimonian and Laird with

heterogeneity and sensitivity analyses. The end-point of interest was the rate

of patients showing seroprotective antibody against hepatitis B surface antigen

at completion of vaccine schedule in the diabetic vs. the nondiabetic dialysis

individuals.

Results  We identified 12 studies involving 1002 unique patients on long-term

dialysis. Aggregation of study results showed a significant decrease in response

rates among the diabetic vs. the nondiabetic patients [pooled odds ratio = 0.52

(95% CI 0.38–0.71)]. The P-value was 0.29 for our test of study heterogeneity.

Stratified analysis in various subgroups of interest did not meaningfully change

our results.

Conclusions  Our meta-analysis showed a clear association between diabetes

mellitus and impaired response to hepatitis B virus vaccine in individuals on

long-term dialysis. Such a relationship is biologically plausible. Vaccination

schedules with adapted vaccine doses and frequent serum testing for loss of

immunity against hepatitis B virus should be considered in patients on

maintenance dialysis with diabetes mellitus.

Link to comment
Share on other sites

Join the conversation

You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...
×
×
  • Create New...