Resposta vacinal de Hepatite B em pacientes renais crônicos em programa dialítico

Abstract

OBJECTIVE: To evaluate the vaccine response against HBV in chronic renal patients in a dialysis program at a reference unit in Aracaju, Sergipe, and to attempt to relate socio-demographic and clinical variables that may influence this response. METHODS: A descriptive cross-sectional study was carried out, consisting of the collection of epidemiological data on 433 patients with terminal dialysis CKD on July 31, 2018. In the data analysis, categorical variables were described using absolute frequency and relative percentage and associations between categorical variables were tested using the Pearson Chi-Square test with a significance level of 5%, and the continuous variables, through Student's T-Test. RESULTS: 342 (85.1%) patients were responders to hepatitis B vaccination. Of these, 30 could not be classified as to the quality of the response and 149 (47.7%) of the 312 classifiable had adequate immune response. Response analysis showed that older patients responded significantly less (p = 0.01), as did diabetics (P = 0.03) and HCV seropositive subjects (p = 0.001). There was insufficient evidence to correlate the variables gender, nutritional status and serum albumin level with the type of vaccine response. CONCLUSION: We observed a high rate of response to hepatitis B vaccination among our patients, suggesting that the proposed vaccination scheme is effective. Most patients presented intermediate titers of Anti-HBs, future comparative analyzes are required, in an attempt to identify possible predictors of high response. Elderly, diabetic and hepatitis C patients appear more susceptible to non-response to vaccination, which is biologically plausible and clinically relevant. These results reinforce the importance of vaccination and the direction of future research, notably chronic diabetic renal disease and HCV coinfection.