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• W2073506575 abstract "Active immunization is crucial for eradicating hepatitis B virus infection from dialysis units. A prospective study was performed in 63 consecutive chronic uremic patients, which included the following: (1) the intramuscular (IM) administration of 40 µg of a DNA-recombinant vaccine (Engerix-B, Smith Kline & French Laboratories, Milan, Italy) to all chronic uremic patients at 0, 1, 2, and 6 months; (2) the antibody titer determination at the seventh month (chronic uremic patients with a titer >100 mIU/mL received an IM booster dose of 40 µg at 18 months [group A], and those with a titer <100 mIU/mL received a further IM dose of 40 µg at 12 months [group B]); and (3) the intradermal inoculation of 5 µg of vaccine every 2 weeks until the protective titer (≥ 10 mIU/mL) was achieved, and then monthly for 6 months, in chronic uremic patients who did not have a protective titer even after 19 months (group C). Thus, 41, 17, and five chronic uremic patients were allocated to groups A, B, and C, respectively. All developed a protective titer: 79.4%, 84.0%, and 87.5% after the fourth, fifth, and sixth IM dose at 7, 13, and 19 months, respectively. Five chronic uremic patients (group C) achieved seroprotection after 3.8 ± 0.5 (SEM) intradermal inoculations. The mean antibody titers at 19 and 36 months were, respectively, 1,344 ± 84 mIU/mL (22 patients) and 1,322 ± 114 mIU/mL (14 patients) in group A, 422 ± 174 mIU/mL (12 patients) and 305 ± 239 mIU/mL (six patients) in group B, and 3.6 ± 1.2 mIU/mL (five patients) and 127 ± 65 mIU/mL (four patients) in group C. A significant difference in antibody titer was found between group A and the two other groups at all time points studied (P < 0.0001). Booster doses to preserve seroprotection were needed in only one group A patient, in five group B patients, and in two group C patients. No significant differences among the three groups concerning age, sex, and time on dialysis were found. No hepatitis B virus infection was detected during the follow-up period. In conclusion, our two-step integrated protocol produces seroprotection in all our chronic uremic patients. It should be considered for reversing non responsiveness in high-risk groups. Active immunization is crucial for eradicating hepatitis B virus infection from dialysis units. A prospective study was performed in 63 consecutive chronic uremic patients, which included the following: (1) the intramuscular (IM) administration of 40 µg of a DNA-recombinant vaccine (Engerix-B, Smith Kline & French Laboratories, Milan, Italy) to all chronic uremic patients at 0, 1, 2, and 6 months; (2) the antibody titer determination at the seventh month (chronic uremic patients with a titer >100 mIU/mL received an IM booster dose of 40 µg at 18 months [group A], and those with a titer <100 mIU/mL received a further IM dose of 40 µg at 12 months [group B]); and (3) the intradermal inoculation of 5 µg of vaccine every 2 weeks until the protective titer (≥ 10 mIU/mL) was achieved, and then monthly for 6 months, in chronic uremic patients who did not have a protective titer even after 19 months (group C). Thus, 41, 17, and five chronic uremic patients were allocated to groups A, B, and C, respectively. All developed a protective titer: 79.4%, 84.0%, and 87.5% after the fourth, fifth, and sixth IM dose at 7, 13, and 19 months, respectively. Five chronic uremic patients (group C) achieved seroprotection after 3.8 ± 0.5 (SEM) intradermal inoculations. The mean antibody titers at 19 and 36 months were, respectively, 1,344 ± 84 mIU/mL (22 patients) and 1,322 ± 114 mIU/mL (14 patients) in group A, 422 ± 174 mIU/mL (12 patients) and 305 ± 239 mIU/mL (six patients) in group B, and 3.6 ± 1.2 mIU/mL (five patients) and 127 ± 65 mIU/mL (four patients) in group C. A significant difference in antibody titer was found between group A and the two other groups at all time points studied (P < 0.0001). Booster doses to preserve seroprotection were needed in only one group A patient, in five group B patients, and in two group C patients. No significant differences among the three groups concerning age, sex, and time on dialysis were found. No hepatitis B virus infection was detected during the follow-up period. In conclusion, our two-step integrated protocol produces seroprotection in all our chronic uremic patients. It should be considered for reversing non responsiveness in high-risk groups." @default.
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• W2073506575 title "Hepatitis B Virus Infection in Chronic Uremia: Long-term Follow-up of a Two-step Integrated Protocol of Vaccination" @default.
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