Factors influencing immune response to different immunization schedules with hepatitis B vaccine in adult hemodialysis patients,and interactions between factors
Objective To explore factors influencing immune response to different immunization schedules with hepatitis B vaccine(HepB)in maintenance hemodialysis(MHD)patients and interactions between factors.Methods We recruited MHD patients aged ≥18 years from 11 hospitals in Shanxi province and randomized consenting patients to receive either a 0-1-6-month 20 µg,a 0-1-2-6-month 20 µg,or a 0-1-2-6-month 60 μg HepB immunization schedule.We tested sera for hepatitis B surface antibody(HBsAb)obtained one month after the last dose of the assigned HepB series schedule to determine factors influencing non-/hypo-response(HBsAb＜100 mIU/mL)and interactions among factors.Results The overall non-/hypo-response rate was 25.55％(116/454)among MHD patients after full-series HepB vaccination.Multivariate logistic regression analysis showed that the non-/hypo-response rate was lower among subjects who received a 0-1-2-6-month 60 µg or a 0-1-2-6-month 20 µg schedule than among subjectswho received a 0-1-6-month 20 μg schedule(OR=0.44,95％CI:0.26-0.75;OR=0.52,95％CI:0.31-0.88);and was higher among subjects ≥50 years of age and subjects with diabetes compared with subjects＜50 years of age and subjects without diabetes(OR=2.02,95％CI:1.29-3.18;OR=1.91,95％CI:1.16-3.12),respectively.There was a multiplicative interaction between immunization schedule and age(OR=1.91,95％CI:1.16-3.14).Conclusions MHD patients who received a routine 0-1-6-month 20 μg HepB immunization schedule,who were older,and who had diabetes were prone to non-/hypo-response to HepB vaccination.There was an interaction between age and immunization schedule.
Maintenance hemodialysisHepatitis B vaccineVaccinationNon-/hypo-responseInfluencing factorInteraction
万方数据
维普
