Intradermal hepatitis B vaccination in patients with advanced chronic renal failure: immunogenicity and follow‐up

Summary Background Patients undergoing dialysis usually have a poor response to conventional hepatitis B vaccination. Aim To observe the effects of intradermal hepatitis B (HB) vaccination in a 13‐month prospective study of adult patients with end‐stage renal failure. The patients were with or without previous hepatitis B vaccination, but all had antibody titres <10 mUI/mL. Methods Patients were allotted to two groups: previous hepatitis B virus vaccination and no previous hepatitis B virus vaccination or anti‐HBs titres <10 mUI/mL. Patients in both groups received 16 i.d. injections of 0.1 mL of hepatitis B virus vaccine over an eight‐week period. Patients had antibody titres assessed before vaccination, 1 month after and every 3 months for a year. Antibody titres ≥10 mUI/mL were considered protective. Results Seventy patients completed the protocol. Protective titres were elicited in 82% of each group. Age, time under dialysis, diabetes, smoking and body‐mass index were not associated with seroconversion. Persistent protective titres >12 months occurred in 27 (58.7%). Adverse events were trivial. Conclusion Intradermal hepatitis B virus vaccination is an alternative in end‐stage renal failure.