VACCINE-INDUCED HEPATITIS-B SURFACE-ANTIGEN POSITIVITY IN ADULT HEMODIALYSIS-PATIENTS - INCIDENTAL AND SURVEILLANCE DATA

This report describes hepatitis B vaccinations that resulted in transi ent hepatitis B surface antigen positivity in six adult hemodialysis p atients. Initially, three patients were incidentally discovered to be hepatitis B surface antigen-positive temporally related to hepatitis B vaccination, Two other patients who displayed transient positivity we re among 15 hemodialysis patients under prospective surveillance after receiving a dose of hepatitis B vaccine. The sixth patient was negati ve for hepatitis B surface antigen when monitored in the prospective s urveillance group but was incidentally found to be positive after a no nsurveillance dose of the vaccine. All positive cases cleared hepatiti s B surface antigen within 20 days of vaccination. In our search of th e literature, this is the first report of hepatitis B vaccine inducing hepatitis B surface antigen positivity in adult hemodialysis patients , Because this study proposes that this transient surface antigen posi tivity is vaccine-induced and not a true hepatitis B infection, we rec ommend that renal dialysis patients not be screened for hepatitis B su rface antigen for at least 21 to 28 days after hepatitis B vaccination , As well, blood donors should not donate blood in this early postvacc ination period. These guidelines would incorporate a measure of safety to prevent individuals in the early postinoculation period from being erroneously labeled as having hepatitis B viral infections.