Publication: Patient factors associated with non-response to the hepatitis B vaccination in haemodialysis patients: A systematic review

Patient factors associated with non-response to the hepatitis B vaccination in haemodialysis patients: A systematic review.
Leather N, Gunnarsson R, Barraclough K, Neuen B, Mantha M, Killen J.
Canberra: Australian and New Zealand Society of Nephrology Annual Scientific Meeting; 2015.

Abstract

Aim:

To systematically review evidence for patient factors associated with nonresponse to the hepatitis B vaccination in patients on haemodialysis.

Background:

It is recommended that all haemodialysis patients are immune against the hepatitis B vaccine, but the quantitative antibody response and persistence of seroconversion is substantially reduced compared to gender and age matched controls.

Methods:

We searched databases to identify studies that assessed demographic, clinical and laboratory variables associated with response or nonresponse to the hepatitis B vaccine in patients on haemodialysis. Quality of studies was assessed using a modified validated checklist. Outcomes assessed included overall response rates, factors associated with response after primary vaccine schedule and factors associated with a transient response. Findings were summarised descriptively.

Results:

We included 33 nonrandomised observational studies. Study quality was overall suboptimal. Of the studies included, the antibody response rate ranged from 40% to 93%. Patient factors associated with a poor antibody response included increased age and diabetes. Other factors such as ethnicity, increased weight, concomitant hepatitis C infection, malnutrition, and inefficient dialysis may also be associated with poor vaccine response.

Conclusions:

Current evidence suggests that patient age and diabetes influence the vaccine response in this population. Further studies are needed to confirm these findings, focusing on modifiable risk factors and to guide future clinical trial priorities.


, from FoU-centrum för primärvård och folktandvård Södra Älvsborg
http://researchweb.org/is/en/foualvsborg/user/publication?ref=2205241