PMID- 31701375
OWN - NLM
STAT- MEDLINE
DCOM- 20210604
LR  - 20210604
IS  - 1724-6059 (Electronic)
IS  - 1121-8428 (Linking)
VI  - 33
IP  - 2
DP  - 2020 Apr
TI  - Hepatitis B virus vaccine immune response and mortality in dialysis patients: a 
      meta-analysis.
PG  - 343-354
LID - 10.1007/s40620-019-00668-1 [doi]
AB  - BACKGROUND: We performed a systematic review and meta-analysis to examine factors 
      associated with HBV immune response in dialysis patients, and the association 
      between the immune response to the HBV vaccine and mortality. METHODS: Electronic 
      databases were searched for studies of dialysis patients that compared the 
      characteristics of HBV vaccine responders and non-responders. Mortality was also 
      analyzed according to the vaccine immune response (defined by hepatitis B surface 
      antibody titer > 10 mIU/mL). Random-effects model meta-analyses were performed to 
      compute a weighted mean difference (WMD), a pooled odds ratio (OR), and a pooled 
      risk ratio (RR) between groups. RESULTS: We identified 61 studies with a total of 
      6628 dialysis patients who completed the course of HBV vaccination, 4582 
      responders (69%) and 2046 non-responders (31%). By meta-analysis, relative to 
      non-responders, HBV vaccine responders had a higher dialysis adequacy as measured 
      by Kt/V (WMD 0.08, P < 0.001), a higher serum albumin (WMD 0.12 gm/dL, 
      P < 0.001), a higher normalized protein catabolic rate (WMD 0.12 gm/kg/day, 
      P = 0.001), a higher hemoglobin (WMD 0.15 gm/L, P = 0.03), and a higher 
      parathyroid hormone level (WMD 44 pg/mL, P = 0.004). HBV vaccine responders were 
      younger (WMD - 4.68 years, P < 0.001), had been on dialysis for longer (WMD 
      2.60 months, P < 0.001), were less likely to have diabetes mellitus (pooled OR 
      0.65, P < 0.001), and were less likely to carry the human leukocyte antigen (HLA) 
      DR3 (pooled OR 0.38, P = 0.01). Compared to non-responders, HBV vaccine 
      responders had lower risk for all-cause mortality (pooled RR 0.64, P < 0.001), 
      and lower risk for cardiovascular-related mortality (pooled RR 0.74, P = 0.02). 
      CONCLUSION: In dialysis patients, the lack of immune response to the HBV vaccine 
      is associated with older age, diabetes mellitus, HLA-DR3 status, shorter time on 
      dialysis, lower nutritional status, lower hemoglobin, lower PTH level, and lower 
      dialysis adequacy. Tackling some of these modifiable factors might improve the 
      HBV vaccine immune response.
FAU - Udomkarnjananun, Suwasin
AU  - Udomkarnjananun S
AD  - Division of Nephrology, Department of Medicine, Faculty of Medicine, King 
      Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, 10330, 
      Thailand.
FAU - Takkavatakarn, Kullaya
AU  - Takkavatakarn K
AD  - Division of Nephrology, Department of Medicine, Faculty of Medicine, King 
      Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, 10330, 
      Thailand.
FAU - Praditpornsilpa, Kearkiat
AU  - Praditpornsilpa K
AD  - Division of Nephrology, Department of Medicine, Faculty of Medicine, King 
      Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, 10330, 
      Thailand.
FAU - Nader, Claudia
AU  - Nader C
AD  - Department of Medicine, St. Elizabeth's Medical Center, Boston, MA, USA.
AD  - Department of Medicine, Tufts University School of Medicine, Boston, MA, USA.
FAU - Eiam-Ong, Somchai
AU  - Eiam-Ong S
AD  - Division of Nephrology, Department of Medicine, Faculty of Medicine, King 
      Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, 10330, 
      Thailand.
FAU - Jaber, Bertrand L
AU  - Jaber BL
AD  - Department of Medicine, St. Elizabeth's Medical Center, Boston, MA, USA.
AD  - Department of Medicine, Tufts University School of Medicine, Boston, MA, USA.
FAU - Susantitaphong, Paweena
AU  - Susantitaphong P
AUID- ORCID: 0000-0001-9813-9219
AD  - Division of Nephrology, Department of Medicine, Faculty of Medicine, King 
      Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, 10330, 
      Thailand. pesancerinus@hotmail.com.
AD  - Research Unit for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, 
      Chulalongkorn University, Bangkok, Thailand. pesancerinus@hotmail.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20191107
PL  - Italy
TA  - J Nephrol
JT  - Journal of nephrology
JID - 9012268
RN  - 0 (Hepatitis B Antibodies)
RN  - 0 (Hepatitis B Vaccines)
SB  - IM
MH  - Hepatitis B/prevention & control
MH  - Hepatitis B Antibodies/blood
MH  - *Hepatitis B Vaccines
MH  - Humans
MH  - *Immunity, Active
MH  - *Renal Dialysis
MH  - Renal Insufficiency/blood/*immunology/*therapy
OTO - NOTNLM
OT  - Dialysis
OT  - HBV vaccine
OT  - Meta-analysis
OT  - Mortality
OT  - Seroresponsiveness
OT  - Systematic review
EDAT- 2019/11/09 06:00
MHDA- 2021/06/05 06:00
CRDT- 2019/11/09 06:00
PHST- 2019/09/09 00:00 [received]
PHST- 2019/10/31 00:00 [accepted]
PHST- 2019/11/09 06:00 [pubmed]
PHST- 2021/06/05 06:00 [medline]
PHST- 2019/11/09 06:00 [entrez]
AID - 10.1007/s40620-019-00668-1 [pii]
AID - 10.1007/s40620-019-00668-1 [doi]
PST - ppublish
SO  - J Nephrol. 2020 Apr;33(2):343-354. doi: 10.1007/s40620-019-00668-1. Epub 2019 Nov 
      7.