Indhumathi, E (2014) A study on seroconversion rate following hepatitis B vaccination in chronic kidney disease population with current immunization strategy. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION : Hepatitis B virus (HBV) infection is an important health problem worldwide and more so with chronic kidney disease patients. More than two billion people are infected with Hepatitis B virus all over the world and about 350 million people are chronic carriers. The prevalence of HBV infection is high in haemodialysis population compared to general population in view of increased exposure to blood products, contamination through needles and haemodialysis machine surface contamination. However with the availability of Hepatitis B vaccination, usage of erythropoietin and screening of blood products, dedicated machine with universal precautions the incidence of HBV infection is reduced in this population. Still HBV infection is a persistent problem and the immune response to vaccination is impaired.The seroconversion rate following Hepatitis B vaccination in healthy individuals is morethan 90% but in patients undergoing haemodialysis it is about 50% -60%. The centre for disease control (CDC) and prevention recommends Hepatitis B vaccination for patients with chronic kidney disease not requiring dialysis 3 doses at 0,1 and 6 months with 20 μg of each dose and for patients undergoing dialysis 4 doses at 0,1,2 and 6 months with 40 μg. This study was done to measure the antiHBS antibody titre following 4 doses of 40 μg of Hepatitis B vaccine in haemodialysis patients and compare with 3 doses of 20 μg in healthy controls. AIMS AND OBJECTIVES : 1. To find out the sero conversion rate following hepatitis B vaccination in Chronic kidney disease population with current immunization schedule and compare it with adult healthy volunteers. 2. To analyze the impact of various factors on immune response following hepatitis B vaccination. 59 CONCLUSION : 1. The seroconversion rate in chronic kidney disease Stage-V patients undergoing haemodialysis following 4 doses of 40μg of recombinant hepatitis B virus vaccine in our study was 82%. 2. The seroconversion rate in healthy adult volunteers with 3 doses of 20μg recombinant HBV vaccine in our study was 100%. 3. Female patients undergoing dialysis showed better immune response than males. 4. Non diabetic patients showed better immune response than diabetic patients. 5. Patients with higher body mass index had higher seroconversion rate than patients with malnutrition. 6. Patients with higher haemoglobin level had better response. 7. Adequately dialyzed patients were found to have better immune response. 8. Age,duration of dialysis and serum albumin had no impact on immune response following HBV vaccination.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | seroconversion rate ; hepatitis B vaccination ; chronic kidney disease ; Population ; current immunization strategy. |
| Subjects: | MEDICAL > Nephrology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 11 Jul 2017 05:40 |
| Last Modified: | 11 Jul 2017 05:40 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1381 |
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