ZINC SUPPLEMENTATION AND HEPATITIS-B VACCINATION IN CHRONIC-HEMODIALYSIS PATIENTS

Chronic uremic patients undergoing hemodialysis show a great risk of h epatitis B infection but a diminished seroconversion rate after hepati tis B vaccination. Since zinc deficiency is a common phenomenon in ure mic patients and zinc deficiency is accompanied by immunosuppression, we investigated the effect of zinc supplementation on the seroconversi on rate after hepatitis B vaccination in these patients. In a prospect ive randomized study, 40 uremic non-responders to one complete hepatit is B vaccination cycle underwent a second hepatitis B vaccination. In 28 of these patients a zinc substitution was performed, the remaining 12 patients served as controls without a zinc substitution. In the tre atment group, 60 mg zincaspartate was given intravenously in a short i nfusion after each hemodialysis session (i.e. 3 x 60 mg/week) for 4 mo nths, i.e. 2 months before and 2 months after the first revaccination. This schedule was confirmed as effective in restoring cellular and hu moral immune parameters in chronic uremic patients in a previous study . The chronic uremic patients showed subnormal predialysis plasma zinc concentrations compared to healthy controls (65 +/- 2.1 mu g/dl versu s 126 +/- 4.6 mu g/dl, p < 0.001). In zinc treated patients plasma zin c concentrations increased to the normal range and were maintained dur ing the treatment period. After hepatitis B vaccination, a seroconvers ion was observed in 5 of the 28 zinc treated patients and in 2 of the 12 controls. The difference between the treatment and the control grou p was not significant. It is concluded, that the diminished response t o hepatitis B vaccination in chronic uremic patients is refractory to zinc supplementation.