Document Detail


Extra-high-dose hepatitis B vaccination does not confer longer serological protection in peritoneal dialysis patients: a randomized controlled trial.
MedLine Citation:
PMID:  20185409     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The response to recombinant hepatitis B vaccine remains suboptimal among the dialysis population. METHODS: In this multi-centre randomized controlled trial, we studied the factors that modify the response to intramuscular Engerix-B vaccination in patients on peritoneal dialysis. The primary aim was to study if a three-dose schedule of extra-high dose (80 microg) of Engerix-B would offer better primary seroconversion and more persistent serological protection than the conventional 40-microg dose. RESULTS: Forty-two peritoneal dialysis patients were randomized to receive the conventional 40-microg Engerix-B dose and 45 patients to 80-microg dose. Seroconversion [hepatitis B surface antibody (anti-HBs) level > or =10 IU/l 3 months after completion of the third dose] occurred in 78.6% of patients after 40-microg Engerix-B dosage treatment versus 62.2% for those receiving 80-microg Engerix-B treatment (P = 0.11). After 12 months, the persistence of protective anti-HBs also did not differ between 40- (45.2%) and 80-microg (51.1%) treatment groups (P = 0.67). In contrast, patients with seroconversion 3 months after the third dose of Engerix-B had a higher normalized protein nitrogen appearance (nPNA) than patients without seroconversion (1.16 +/- 0.25 versus 0.96 +/- 0.23 g/kg/day, P = 0.001). Conclusions. We found no evidence of a worthwhile clinical benefit from increasing the three-dose intramuscular Engerix-B vaccine from 40- to 80-microg dose. An unplanned analysis suggested a role of improved protein intake to improve the immune response to hepatitis B vaccine in peritoneal dialysis patients.
Authors:
Kai Ming Chow; Stanley Hok King Lo; Cheuk Chun Szeto; Sze Kit Yuen; Kin Shing Wong; Bonnie Ching Ha Kwan; Chi Bon Leung; Philip Kam-Tao Li
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-02-24
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  25     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-25     Completed Date:  2010-11-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  2303-9     Citation Subset:  IM    
Affiliation:
Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China. Chow_Kai_Ming@alumni.cuhk.net
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MeSH Terms
Descriptor/Qualifier:
Aged
Dose-Response Relationship, Drug
Female
Hepatitis B / immunology,  prevention & control*
Hepatitis B Surface Antigens / blood
Hepatitis B Vaccines / immunology,  therapeutic use*
Hepatitis B virus / immunology*
Humans
Kidney Failure, Chronic / therapy*
Male
Middle Aged
Peritoneal Dialysis*
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Engerix-B; 0/Hepatitis B Surface Antigens; 0/Hepatitis B Vaccines
Comments/Corrections
Comment In:
Nephrol Dial Transplant. 2010 Jul;25(7):2047-9   [PMID:  20466682 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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