Department of Microbiology, Jawaharlal Nehru Medical College, AMU, Aligarh, India.
Abstracts of the papers presented at the XVIII National Conference of Indian Virological Society at Post Graduate Institute of Medical Education and Research, Chandigarh, India, December 11–13, 2008.
Dialysis patients have a tendency to become chronic carriers of HBsAg because of the defective immune response associated with uremia. The vaccine has helped to decrease the incidence further, but with suboptimal efficacy in patients with chronic renal failure. The study was conducted to know the efficacy of 4 doses of 40μg vaccine in chronic kidney disease patients as compared to 3 doses of 20μg vaccine schedule given to normal healthy population. 130 patients of chronic kidney disease were included in this study. Of these 84 were given 20ìg vaccine (52 patients were given 3 doses at 0, 1 and 2 months and 32 patients were given 4 doses at 0, 1, 2 and 6 months) and 46 patients were given 40ìg vaccine (30 patients were given 3 doses at 0, 1 and 2 months and 16 patients were given 4 doses at 0,1,2 and 6 months). The patient response was assessed by measuring antibodies to hepatitis B surface antigen (anti HBs) 1 month after receiving the third and fourth doses each. 57.7% of the patient who received 3 doses of 20ìg vaccine showed seroprotection while 68.7% of the patients who received 4 doses of this vaccine showed seroprotection. On the other hand 60% of the patients who received 3 doses of 40ìg vaccine had seroprotective antibody titers while 87.5% of the patients receiving 4 doses of 40ìg vaccine showed seroprotection. p<0.05 Excellent seroprotection rates were obtained with 40 ìg of vaccine in patients with severe degree of chronic kidney disease (p<0.001) as against 20 ìg of vaccine in which no seroprotection was achieved. Similarly a significant increase in seroprotection was obtained in the older age group (51-60 years) with 4 doses of 40 ìg vaccine p < 0.001. Seroprotection after 4 doses of 40ìg vaccine at 0, 1, 2, and 6 months was found to be better and cost effective in chronic kidney disease patients as compared to 3 doses of 20ìg vaccine schedule given to normal healthy individuals with adequate renal function.
