Immunogenicity of Augmented Compared With Standard Dose Hepatitis B Vaccine in Pediatric Patients on Dialysis : a Midwest Pediatric Nephrology Consortium Study
Copyright © 2017 by the American Society of Nephrology..
BACKGROUND AND OBJECTIVES: Patients on maintenance dialysis have a higher risk of unresponsiveness to hepatitis B vaccination and loss of hepatitis B immunity. Adult guidelines recommend augmented dosing (40 mcg/dose), resulting in improved response in adults. We sought to determine whether children on dialysis mount a similar antibody response when given standard or augmented dosing of hepatitis B vaccine.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This is a retrospective review of patients on dialysis aged <19 years from May 1, 2008 to May 1, 2013 at 12 pediatric dialysis units. Hepatitis B surface antibody (HBsAb) titers ≥10 mIU/ml were defined as protective.
RESULTS: A total of 187 out of 417 patients received one or more hepatitis B vaccine boosters. The median age was 13 years; the cohort was 57% boys and 59% white. Booster dose or HBsAb titers were missing in 17 patients. Conversion to protective HBsAb titers was achieved in 135 out of 170 patients (79%) after their first single-dose booster or multidose booster series. In patients receiving a single-dose booster, the response rate was 53% (nine out of 17) after a 10 mcg dose, 86% (65 out of 76) after a 20 mcg dose, and 65% (17 out of 26) after a 40 mcg hepatitis B vaccine dose. In patients receiving a multidose booster series, the response rate was 95% (19 out of 20) after a 10 mcg/dose series, 83% (20 out of 24) after a 20 mcg/dose series, and 71% (five out of seven) after a 40 mcg/dose series. Patients receiving a multidose booster series had a response rate of 86% (44 out of 51), compared with 76% (91 out of 119) in patients receiving a single-dose booster (P=0.21). Twenty-seven patients received more than one single-dose booster or multidose series, and 26 out of 27 (96%) eventually gained immunity after receiving one to three additional single-dose boosters or multidose booster series.
CONCLUSIONS: There was no clear gradient of increasing seroconversion rate with increasing vaccine dose in this cohort of pediatric patients on dialysis.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:12 |
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| Enthalten in: |
Clinical journal of the American Society of Nephrology : CJASN - 12(2017), 5 vom: 08. Mai, Seite 772-778 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Misurac, Jason M [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 05.03.2018 Date Revised 13.08.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.2215/CJN.04750416 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM269616950 |
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| 100 | 1 | |a Misurac, Jason M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Immunogenicity of Augmented Compared With Standard Dose Hepatitis B Vaccine in Pediatric Patients on Dialysis |b a Midwest Pediatric Nephrology Consortium Study |
| 264 | 1 | |c 2017 | |
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| 500 | |a Date Completed 05.03.2018 | ||
| 500 | |a Date Revised 13.08.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2017 by the American Society of Nephrology. | ||
| 520 | |a BACKGROUND AND OBJECTIVES: Patients on maintenance dialysis have a higher risk of unresponsiveness to hepatitis B vaccination and loss of hepatitis B immunity. Adult guidelines recommend augmented dosing (40 mcg/dose), resulting in improved response in adults. We sought to determine whether children on dialysis mount a similar antibody response when given standard or augmented dosing of hepatitis B vaccine | ||
| 520 | |a DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This is a retrospective review of patients on dialysis aged <19 years from May 1, 2008 to May 1, 2013 at 12 pediatric dialysis units. Hepatitis B surface antibody (HBsAb) titers ≥10 mIU/ml were defined as protective | ||
| 520 | |a RESULTS: A total of 187 out of 417 patients received one or more hepatitis B vaccine boosters. The median age was 13 years; the cohort was 57% boys and 59% white. Booster dose or HBsAb titers were missing in 17 patients. Conversion to protective HBsAb titers was achieved in 135 out of 170 patients (79%) after their first single-dose booster or multidose booster series. In patients receiving a single-dose booster, the response rate was 53% (nine out of 17) after a 10 mcg dose, 86% (65 out of 76) after a 20 mcg dose, and 65% (17 out of 26) after a 40 mcg hepatitis B vaccine dose. In patients receiving a multidose booster series, the response rate was 95% (19 out of 20) after a 10 mcg/dose series, 83% (20 out of 24) after a 20 mcg/dose series, and 71% (five out of seven) after a 40 mcg/dose series. Patients receiving a multidose booster series had a response rate of 86% (44 out of 51), compared with 76% (91 out of 119) in patients receiving a single-dose booster (P=0.21). Twenty-seven patients received more than one single-dose booster or multidose series, and 26 out of 27 (96%) eventually gained immunity after receiving one to three additional single-dose boosters or multidose booster series | ||
| 520 | |a CONCLUSIONS: There was no clear gradient of increasing seroconversion rate with increasing vaccine dose in this cohort of pediatric patients on dialysis | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Adolescent | |
| 650 | 4 | |a Adult | |
| 650 | 4 | |a Antibody Formation | |
| 650 | 4 | |a Child | |
| 650 | 4 | |a Hepatitis B | |
| 650 | 4 | |a Hepatitis B Antibodies | |
| 650 | 4 | |a Hepatitis B Vaccines | |
| 650 | 4 | |a Humans | |
| 650 | 4 | |a Male | |
| 650 | 4 | |a Retrospective Studies | |
| 650 | 4 | |a Seroconversion | |
| 650 | 4 | |a Vaccination | |
| 650 | 4 | |a hemodialysis | |
| 650 | 4 | |a nephrology | |
| 650 | 4 | |a peritoneal dialysis | |
| 650 | 4 | |a renal dialysis | |
| 650 | 7 | |a Biomarkers |2 NLM | |
| 650 | 7 | |a Hepatitis B Antibodies |2 NLM | |
| 650 | 7 | |a Hepatitis B Vaccines |2 NLM | |
| 700 | 1 | |a VanDeVoorde, Rene G |e verfasserin |4 aut | |
| 700 | 1 | |a Kallash, Mahmoud |e verfasserin |4 aut | |
| 700 | 1 | |a Iorember, Franca M |e verfasserin |4 aut | |
| 700 | 1 | |a Luckritz, Kera E |e verfasserin |4 aut | |
| 700 | 1 | |a Rheault, Michelle N |e verfasserin |4 aut | |
| 700 | 1 | |a Jetton, Jennifer G |e verfasserin |4 aut | |
| 700 | 1 | |a Turman, Martin A |e verfasserin |4 aut | |
| 700 | 1 | |a Kapur, Gaurav |e verfasserin |4 aut | |
| 700 | 1 | |a Twombley, Katherine E |e verfasserin |4 aut | |
| 700 | 1 | |a Hashmat, Shireen |e verfasserin |4 aut | |
| 700 | 1 | |a Weaver, Donald J |e verfasserin |4 aut | |
| 700 | 1 | |a Leiser, Jeffrey D |e verfasserin |4 aut | |
| 700 | 1 | |a Nailescu, Corina |e verfasserin |4 aut | |
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