Recombinant hepatitis B vaccine use in chronic hemodialisys patients : Long-term evaluation and cost-effectiveness analysis.
The prevalence of hepatitis B virus (HBV) infection in our unit was 45% (86/190) : there were 77 (40.5%) and 9 (4.7%) patients with previous and persistent HBV infection, respectively.
Recombinant hepatitis B vaccine was given to 118 chronic HD patients with a regimen of 3 double doses administered intramuscularly at 0,1 and 2 months, obtaining a seroprotection rate of 67% (79/118), 57% (45/79) being high responders.
At month 24,78% (40/51) maintained protective levels of anti-HBs, 45% (18/40) of them being high responders.
There was a statistically significant difference between responder and nonresponder patients with regard to nutritional parameters such as serum total proteins and mean levels of transferrinemia.
The number of diabetic patients was significantly increased in the nonresponder group.
Patients with persistent antibodies ('persistent responders') were younger and had a shorter duration of HD treatment compared to those responders who rapidly lost anti-HBs ('transient responders'). Serological positivity for antibodies against hepatitis B core antigen significantly facilitates the decrease of anti-HBs antibodies over time.
We detected seven episodes of HBV infection among HD patients at our unit before the beginning of the vaccination program.
On the contrary, there were no episodes of HBV infection among responder vaccinees during the 24-month follow-up period.
After the initial cost of vaccination, a savings of US$ 3,272 per year was reali...
Mots-clés Pascal : Hémodialyse, Complication, Hépatite virale B, Virose, Infection, Chronique, Prévention, Vaccination, Protéine recombinante, Résultat, Long terme, Analyse avantage coût, Homme, Epuration extrarénale, Appareil digestif pathologie, Foie pathologie, Santé publique
Mots-clés Pascal anglais : Hemodialysis, Complication, Viral hepatitis B, Viral disease, Infection, Chronic, Prevention, Vaccination, Recombinant protein, Result, Long term, Cost benefit analysis, Human, Extrarenal dialysis, Digestive diseases, Hepatic disease
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0177020
Code Inist : 002B05A02. Création : 199608.