HEPATITIS-B VACCINE IN HEMODIALYSIS-PATIENTS WITH HEPATITIS-C VIRAL-INFECTION

Patients on hemodialysis therapy are at a relatively high risk of expo sure to hepatitis B virus (HBV) infection. The prevalence of hepatitis C virus (HCV) infection is even higher and was reported as 33.2% in T aiwan. Although the efficacy of hepatitis B vaccine as well documented , the vaccination schedule in hemodialysis patients is not clearly def ined. And under such a high prevalence of HCV infection, little is kno wn about the influence of HCV imposing on HBV vaccination. We studied 50 chronic hemodialysis patients who were serologically negative for t he hepatitis B surface antigen (HBsAg), the antibody to the hepatitis B surface antigen (anti-HBs and the antibody to the hepatitis B core a ntigen (anti-HBc); 26 of them were positive for the antibody to hepati tis C virus (anti-HCV) test. Recombinant hepatitis B vaccine (Engerix- B) 40 mu g per dose was administered by the intramuscular route at del toid region at 0, 1, 2, 6 and 12 months respectively to all the patien ts. Forty-six patients had completed the study. The effective seroconv ersion rate (serum anti-HBs titer > 10 mIU ml(-1)) at 1 month after th e final vaccine was 76.1% (35/46). The effective conversion rates of t he anti-HCV (+) group to the anti-HCV(-) were 75% versus 77.3% (P=0.85 7). Geometric mean anti-HBs titers were 177.67 mIU ml(-1) versus 189.2 8 mIU ml(-1) (P=0.867). Our results showed that five-dose injections o f HBV vaccine do not present a superior outcome to the four-dose regim en comparing to published data. The status of positivity of anti-HCV d o not pose an suboptimal effect on HBV vaccination of hemodialysis pat ients. (C) 1997 Elsevier Science Ltd.