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首页> 外文期刊>International Journal of General Medicine >Hemodialysis and hepatitis B vaccination: a challenge to physicians
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Hemodialysis and hepatitis B vaccination: a challenge to physicians

机译：血液透析和乙肝疫苗接种：对医生的挑战

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Abstract: Hepatitis B is responsible for the development of half of hepatocellular carcinoma cases and is a major cause of hepatic insufficiency. The vaccine against hepatitis B virus does not exhibit the same high efficacy in patients on hemodialysis as it does in immunocompetent individuals. The medical literature recommends vaccination with four doses (40 mg each) of the hepatitis B virus vaccine before beginning hemodialysis; however, approximately one-third of hemodialysis patients do not respond to this vaccination schedule. A new serologic test should be performed each year for individuals who respond adequately, whereas a booster dose should be offered to those with antibody titers below 10 mIU/mL. In this study, we followed 83 hemodialysis patients and collected quantitative serologic measurements every 2 months over a 1-year period. We made the measurements 1 month after the vaccination period. We found that 41% of the patients had antibody titers below 10 mIU/mL (nonresponders), 21.7% had antibody titers between 10 mIU/mL and 100 mIU/mL (poor responders), and 37.3% had antibody titers higher than 100 mIU/mL (good responders). Patients with diabetes and/or hypertension exhibited worse response to vaccination. All subjects displayed decreasing antibody titers during the observation period. The group of poorly responsive patients had antibody titers below 10 mIU/mL at the 6-month follow-up period.
机译：摘要：乙型肝炎负责一半的肝细胞癌病例的发展，是肝功能不全的主要原因。抗乙肝病毒疫苗在血液透析患者中​​没有表现出与具有免疫能力的个体相同的高效性。医学文献建议在开始血液透析之前先接种四剂（每次40毫克）乙型肝炎病毒疫苗。但是，大约有三分之一的血液透析患者对此疫苗接种时间表没有反应。每年应对反应良好的个体进行新的血清学检测，而抗体滴度低于10 mIU / mL的个体应增加剂量。在这项研究中，我们追踪了83名血液透析患者，并在1年的期间内每2个月收集了定量的血清学测量值。接种期后1个月进行测量。我们发现41％的患者抗体滴度低于10 mIU / mL（无反应），21.7％的患者抗体滴度在10 mIU / mL至100 mIU / mL之间（反应不良），37.3％的患者抗体滴度高于100 mIU / mL（良好的响应者）。糖尿病和/或高血压患者对疫苗的反应较差。在观察期间，所有受试者显示出降低的抗体滴度。反应不良的患者组在6个月的随访期间抗体滴度低于10 mIU / mL。

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