Meta-analysis: the dialysis mode and immunological response to hepatitis B virus

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Meta-analysis: the dialysis mode and immunological response to hepatitis B

virus vaccine in dialysis population

Authors: FABRIZI, F.1; DIXIT, V.2; BUNNAPRADIST, S.3; MARTIN, P.4

Source: Alimentary Pharmacology & Therapeutics, Volume 23, Number 8, April

2006, pp. 1105-1112(8)

Publisher:Blackwell Publishing

Abstract:

Summary Background & #8194;

Patients on maintenance dialysis typically show a suboptimal immune response

to hepatitis B virus vaccine compared with the non-uraemic population. Some

authors have claimed that dialysis mode has an impact on the immune response

to hepatitis B virus vaccine but consistent information is lacking on this

issue. Aim & #8194;

To evaluate the relationship between dialysis mode and immune response to

hepatitis B vaccine in dialysis population by performing a systematic review

with a meta-analysis of clinical trials. Method & #8194;

We used the random effects model of DerSimonian and Laird; sources of

heterogeneity in effect estimates were explored by performing sensitivity

analyses. Results & #8194;

The relative risk of failure to respond to hepatitis B vaccine among

patients who underwent maintenance haemodialysis vs. peritoneal dialysis was

the end point of interest. We identified 14 clinical trials involving 1211

unique patients on maintenance dialysis. Pooling of study results did not

show a significant decreased risk of response to hepatitis B vaccine among

haemodialysis patients (overall risk ratio: 1.0, 95% confidence intervals:

0.92–1.1). The P-value was 0.13 for our test of study heterogeneity.

Conclusion & #8194;

There is no significant link between dialysis mode and seroresponse to

hepatitis B virus vaccine in dialysis population.

Document Type: Research article

DOI: 10.1111/j.1365-2036.2006.02877.x

Affiliations: 1: Division of Nephrology and Dialysis, Maggiore Hospital,

IRCCS, Milano, Italy 2: Division of Digestive Diseases, UCLA School of

Medicine, Los Angeles, CA, USA 3: Division of Nephrology, Cedars-Sinai

Medical Center and UCLA School of Medicine, Los Angeles, CA, USA 4: Division

of Liver Diseases, MountSinai School of Medicine, New York, NY, USA

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