Hanif Farina M, Mehmood Nasir, Majid Zain, Luck Nasir H, Laeeq S Mudassir, Tasneem Abbas A, Ul Haque Muhammad Manzoor
Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan.
Saudi J Gastroenterol. 2020 Oct 28;26(6):306-11. doi: 10.4103/sjg.SJG_300_20.
Hepatitis B infection is one of the most common infections worldwide, with its vaccination being an effective preventive measure. Nonresponse to hepatitis B vaccination increases population susceptibility to virus dissemination along with detrimental complications. Despite twice intramuscular vaccination series, 14.3% in the general population and 50% in hemodialysis patients fail to mount a response against hepatitis B. We aimed to evaluate the effectiveness of intradermal (ID) vaccination in the nonresponders amongst the general and hemodialysis population.
A total of 5 doses of 10 μg of hepatitis B vaccine was given intradermally, 2 weeks apart, to both the study groups: patients who were on hemodialysis and the general population group who previously had failed to achieve satisfactory antibody titers with the IM administration of the vaccine. A hepatitis B surface antibody (HBsAb) titer of ≥10 IU/mL and ≥100 IU/mL were considered "responder" and "good responder," respectively.
Out of a total of 95 participants, 49 (51.6%) were hemodialysis-dependent. Most of the participants were females 49 (51.6%). The mean age of all the participants was 39.02 ± 13.5 years (range: 18-70 years). Overall, 75.8% of the participants responded to the ID vaccination with a mean HBsAb titer of 263.5 ± 350.1 IU/L. Almost similar vaccination response was observed in both the hemodialysis and general population i.e., 75.5% and 76.1%, respectively (P = 1.00). In the hemodialysis group, the absence of hypertension (P = 0.04) and age ≥36 years (P = 0.016) were associated with an ID vaccination response.
For those not responding to the conventional IM route of the hepatitis B vaccine, the ID route is an effective way of immunization in this group and this approach would lead to a decrease in infection rates in the vulnerable population such as those on hemodialysis.
乙型肝炎感染是全球最常见的感染之一，接种疫苗是一种有效的预防措施。对乙型肝炎疫苗无反应会增加人群对病毒传播的易感性以及不良并发症。尽管进行了两次肌内接种系列，但普通人群中有14.3%以及血液透析患者中有50%对乙型肝炎疫苗无反应。我们旨在评估皮内（ID）接种疫苗在普通人群和血液透析人群中无反应者中的有效性。
给两个研究组皮内注射总共5剂10μg的乙型肝炎疫苗，间隔2周，这两个研究组分别是接受血液透析的患者和之前肌内注射疫苗后未获得满意抗体滴度的普通人群组。乙型肝炎表面抗体（HBsAb）滴度≥10 IU/mL和≥100 IU/mL分别被视为“有反应者”和“良好反应者”。
在总共95名参与者中，49名（51.6%）依赖血液透析。大多数参与者为女性，共49名（51.6%）。所有参与者的平均年龄为39.02±13.5岁（范围：18至70岁）。总体而言，75.8%的参与者对皮内接种疫苗有反应，平均HBsAb滴度为263.5±350.1 IU/L。在血液透析人群和普通人群中观察到几乎相似的接种反应，分别为75.5%和76.1%（P = 1.00）。在血液透析组中，无高血压（P = 0.04）和年龄≥36岁（P = 0.016）与皮内接种疫苗反应相关。
对于那些对常规乙型肝炎疫苗肌内接种无反应的人，皮内接种途径是该组有效的免疫方法，这种方法将导致易感人群如血液透析患者的感染率降低。
