Background. The presence of surface antigen of hepatitis B (HBsAg) virus in
serum from recently vaccinated adults has been scarcely investigated. In t
his work, after the detection by chance of seven HBsAg-positive patients on
hemodialysis who reported recent hepatitis B vaccination, a prospective st
udy was undertaken to verify the presence and duration of post-vacunal anti
genemia.
Patients and methods. Nineteen non-selected patients on hemodialysis were f
ollowed for serologic markers of hepatitis B, after receiving a dose of the
recombinant vaccine (Engerix B) according to their vaccination schedule. E
nzyme-immunoassay techniques were used for the study of serologic markers,
and the reactivity of HBsAg was confirmed by means of a neutralization assa
y with specific anti-HBs antibodies.
Results. After the administration of one vaccine dose, 31.5% of patients we
re HBsAg positive at least once. Antigenemia was identified more frequently
2 to 4 days (83.3%) after inmunization. In all cases antigenemia was trans
ient and had cleared after 11 days of vaccination. The follow-up of serolog
ic markers revealed the absence of infection with virus B. Only 16.6% of pa
tients with transient antigenemia responded to vaccination (titer of anti-H
Bs greater than or equal to 10 mIU/ml), while the corresponding percentage
in the group of HBsAg-negative patients was 69.2% (p < 0.05). All patients
were HCV and HIV negative.
Conclusions. A high frequency of post-vacunal antigenemia is reported in pa
tients on hemodialysis, in absence of virus B infection as well as the poss
ible relationship between the presence of transient antigenemia and the non
-responder status.