AI Article Synopsis
- Patients with chronic kidney disease (CKD) show lower immune responses to hepatitis B vaccinations, prompting a study on the effectiveness of different dosing regimens.
- A randomized controlled trial evaluated the immunogenicity of three and four doses of both standard (20 µg) and high (60 µg) hepatitis B vaccines over 18 months.
- Results indicated that the group receiving the four doses of the high vaccine (60 µg) had better durability of immune response compared to those receiving fewer doses or lower strength, particularly for CKD patients not undergoing immunosuppressive treatments.
Article Abstract
Background: Patients with chronic kidney disease (CKD) have immunological defects that result in reduced production and faster decay of anti-HBs after hepatitis B vaccination. We assessed the duration of the immunogenicity after four-standard-dose and four-triple-dose regimens among patients with CKD.
Methods: A randomized controlled trial was conducted between May 2019 and February 2020. Patients were randomly allocated to receive three or four doses of 20 µg , or four doses of 60 µg of hepatitis B vaccine. Immunogenicity was assessed for 18 months till February 2021.
Results: Between months 7 and 18, the seroconversion rate decreased from 81.7% (58/71) to 64.3% (36/56) in IM20 × 3 group, from 93.0% (66/71) to 77.4% (41/53) in IM20 × 4 group, and from 93.2% (68/73) to 90.7% (49/54) in IM60 × 4 group. Seroconversion was higher in IM60 × 4 group than in IM20 × 3 group at month 18 ( < 0.05). In multivariate analysis, CKD patients without immune suppression or hormone therapy or patients with IM60 × 4 were more likely to have durable immunogenicity at month 18.
Conclusions: Patients receiving four-triple-dose regimen of hepatitis B vaccine showed improved duration of immunogenicity at the one-year follow-up.
Clinical Trial Registration: ClinicalTrials.gov (NCT03962881).
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| http://dx.doi.org/10.1080/14760584.2022.2112951 | DOI Listing |
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