Falla en la producción de anticuerpos con la vacuna del virus de la hepatitis B en pacientes dializados: incidencia y factores asociados

Marcelo Aguirre Caicedo; Francisco Molina; Nelson Giraldo; Mauricio Uribe Betancur

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Published: 2011-12-15

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Aguirre Caicedo, M., Molina, F., Giraldo, N., & Uribe Betancur, M. (2011). Failure in the antibodies production with hepatitis B vaccine in dialyzed patients: incidence and associated factors. Medicina UPB, 30(2), 141-149. https://revistas.upb.edu.co/index.php/medicina/article/view/1797

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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Societal impact

Marcelo Aguirre Caicedo

San Francisco de Asís Hospital

Francisco Molina

Pontifical Bolivarian University

Nelson Giraldo

Hospital Pablo Tobon Uribe

Mauricio Uribe Betancur

Pontifical Bolivarian University

Abstract

Objective: to get to know the incidence of non-seroconversion after vaccination for hepatitis B in dialysis patients, and to establish the associated factors with the lack of antibody production.

Methods: multicenter retrospective cohort study in Medellin. Patients with chronic renal failure who started hemodialysis or peritoneal dialysis between January 2006 and June 2008 were included. Vaccination schedule: 4 doses of 40 mcg HepavaxGene ®, with measurement of antibodies 4 weeks later. A lack of response was considered if: titles < 10 U. We analyzed gender, age, race, diabetes, blood transfusions, erythropoietin, creatinine, ferritin, hemoglobin, albumin, and type of dialysis. Binary logistic regression was done to identify associated factors with the vaccination response and multiple linear regression “stepwise” to predict the levels of antibodies.

Results: 237 patients were included. That reached protective antibody titers 153 patients (63.9%). The response prediction formula is: Ln Y = (1.88) + (0.97 X Albumin) – (0.00024 X Age) – (0.097 X Creatinine) – (0.47 X Women) – (0.49 X Hemodialysis), Y= antibody title. The albumin greater than 3 g/dl was associated with titers greater than 10 U. OR = 4.92, (95% CI 2.09 - 12.37).

Conclusions: the incidence of the seroconversion after vaccination against the virus of hepatitis B in patients in dialysis is 63%. The elderly (> 65 years old) and hypoalbuminemia (<3 g/dl) were associated to a smaller response to the vaccination.>< 3 g/dl) were associated to a smaller response to the vaccination.

Keywords:

vaccines, hepatitis B, antibodies, kidney failure, chronic, renal dialysis, peritoneal dialysis

Author Biographies

Marcelo Aguirre Caicedo, San Francisco de Asís Hospital

Internist, nephrologist and epidemiologist. San Francisco de Asís Hospital, Caprecom Clinic, Chocó Family Compensation Fund "Comfachoco", Chocó Cardiodiagnosis. Quibdó, Colombia.

Francisco Molina, Pontifical Bolivarian University

Internist, intensivist, epidemiologist. Bolivarian University Clinic, CORBIC Institute. Medellin Colombia.

Nelson Giraldo, Hospital Pablo Tobon Uribe

Anesthesiologist, intensivist and statistician. Pablo Tobón Uribe Hospital. Medellin Colombia.

Mauricio Uribe Betancur, Pontifical Bolivarian University

Internist, nephrologist, professor. Faculty of Medicine, Universidad Pontificia Bolivariana.

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