The evaluation of immune responses to hepatitis B vaccination in diabetic and non-diabetic haemodialysis patients and the use of tetanus toxoid

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http://www3.interscience.wiley.com/journal/120124527/abstract?CRETRY=1 & SRETRY=0

Nephrology

Published Online: 6 Mar 2008

Original Article

The evaluation of immune responses to hepatitis B vaccination in diabetic and

non-diabetic haemodialysis patients and the use of tetanus toxoid

SABAHATTIN OCAK 1 and ALI FUAT ESKIOCAK 2

1 Department of Infectious Diseases and Clinical Microbiology, Medical

Faculty, Mustafa Kemal University, and 2 Antakya Haemodialysis Center, Hatay,

Turkey

Correspondence to Dr Sabahattin Ocak, Mustafa Kemal Üniversitesi, Týp

Fakültesi, Dekanlýgý, Hatay 31100, Turkey. Email: sabahattinocak@...

ABSTRACT

Aim: The aim of this study was to investigate whether haemodialysis (HD)

patients suffering from diabetes mellitus could be considered at risk for the

development of the protective antibodies to hepatitis B (HB) vaccination and, to

evaluate the effectiveness of tetanus toxoid (TT) administrated 2 days before HB

vaccination.

Methods: Forty-nine HD patients were divided into two groups: group A (19

diabetic patients) and group B (30 non-diabetic patients). A dose of 40 μg

recombinant HB vaccine was injected intramuscularly to the patients at 0, 1, 2

and 6 months.

Results: After the completion of the course, the patients in group A were found

to have a lower protective antibody rates than the patients in group B (57.8% vs

70%) (P> 0.05). After the administration of additional booster doses during 12

months, the protective antibody to hepatitis B surface antigen (HBsAb) levels

were detected in 78.9% and 96.6% of the patients in group A and group B,

respectively (P> 0.05). The patients not having protective HBsAb levels were

administered TT and HB vaccines, and after course, all of them have produced

protective HBsAb levels.

Conclusion: The present study showed that diabetic patients on HD may carry a

greater risk of not seroconverting than non-diabetic ones for antibody response

to HB vaccination. The use of TT 2 days before HB vaccination may be a useful

and effective method of enhancing the immune response to HB vaccination,

especially in the patients with diabetes mellitus on HD.

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