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HBV Vaccination in Chronic Renal Failure Patients

AUTHORS

Shahnaz Sali 1 , *

AUTHORS INFORMATION

1 Infectious Disease Specialist, Fayyaz Bakhsh Hospital, Tehran Social Security, Tehran, IR.Iran

How to Cite: Sali S. HBV Vaccination in Chronic Renal Failure Patients, Hepat Mon. Online ahead of Print ; 6(1):25-29.

ARTICLE INFORMATION

Hepatitis Monthly: 6 (1); 25-29
Article Type: Review Article
Received: January 1, 2006
Accepted: January 1, 2006

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Abstract

HBV infection in chronic renal failure (CRF) becomes chronic in 30 to 60% compared with less than 10% in nonuremic patients.

Immunological dysfunction in patients on hemodialysis may be related to imbalanced cytokine systems, such as tumor necrosis factor (TNF-|α|) and interleukin (IL) 6,1 by retention of renal metabolite in uremia and chronic inflammation and have a poor immunological reaction to T-cell-dependent antigens, like hepatitis B vaccination. Immunocompromised patients who are unresponsive to hepatitis B vaccination seem to be unable to enhance IL-10 synthesis for control of monokine overproduction.

Moreover, human leukocyte antigen (HLA) genes, which play a major role in the antigen presentation to immunocompetent cells, have also been shown to modulate this immune response.

Unfortunately, seroconversion to anti-HBS has been reported to occur in only 40 to 50% of the vaccine, a significantly lower rate than that observed in healthy adults. Various methods including adjutants such as zinc, gamma interferon, thymopentine, GM-CSF and Levamisol for improving immune responses have been advised. Experience with Pres1/s2, third-generation vaccines is limited and they have not been proven more effective than intradermally (ID) administered second-generation S antigen vaccines.

Both intramuscular (IM) and intradermal (ID) vaccinations against hepatitis B have variable efficiency in hemodialysis and non-responders should be retreated by ID route.

Keywords

CRF, Vaccination, Hepatitis B, Immunoresponse, TNFa, Interleukin, Pre-S Vaccine

© 0, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

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