LOW RATES OF HEPATITIS B IMMUNITY IN CENTRE HAEMODIALYSIS PATIENTS

M MORRIS1, H GOCK1,2,

1Department of Nephrology; 2Department of Medicine, University of Melbourne, St Vincent’s Hospital, Melbourne, AUSTRALIA

Background: Hepatitis B vaccination and immunity in haemodialysis (HD) dialysis patients is an important preventative measure given Hepatitis B is highly infectious and transmission has been reported between haemodialysis patients despite stringent standard precautions.

Aim: To determine the prevalent Hepatitis B immunity status at a single metropolitan satellite haemodialysis unit to ensure our screening and vaccination policy is effective.

Methods: Current hepatitis serology from 2017 on all patients (n=59, 100%) at our main metropolitan satellite were examine for hepatitis B status and immunity using Hepatitis B Surface Antigen (HBSAg), Hepatitis B Surface Antibody (HBSAb), and Hepatitis B Core Antibody (HepBCAb).  The country-of-birth of patients was also noted.

Results: 14 (24%) patients were HBSAg-/HBSAb+ and 25 (42%) patients were HBSAg-/HBSAb- indicating no protective immunity and suggesting that only 36% (14/39) of patients in our HD population could be successfully vaccinated.  19 (32%) were HBSAg-/HBCAb+ and all of these patients were born overseas compared to no difference in proportion of Australian and overseas born in all other groups.  Taking into account the HepBCAb+ group, the total patients with some  with some protective immunity reaches 56% (14+19). There was 1 (2%) patient with HBSAg+ with chronic infection who was Australian born.

Conclusions: A substantial proportion of HD patients have no protective immunity to Hepatitis B and vaccination appears to be successful in only 1 in 3 patients.  Therefore, checking Hepatitis B status early in CKD and vaccination prior to dialysis may improve protective immunity rate in HD units.

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