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Hepatitis C virus and the immunological response to hepatitis B virus vaccine in dialysis patients: meta‐analysis of clinical studies
Author(s) -
Fabrizi F.,
Dixit V.,
Martin P.,
Messa P.
Publication year - 2011
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/j.1365-2893.2011.01459.x
Subject(s) - medicine , seroconversion , dialysis , hepatitis c virus , immunology , hepatitis b virus , population , hepatitis b vaccine , hepatitis b , vaccination , meta analysis , hepatitis c , virus , hbsag , environmental health
Summary. It is well known that the seroconversion rate of patients following hepatitis B virus (HBV) vaccination is lower in uraemic than healthy subjects. A variety of inherited or acquired factors have been implicated in this diminished response, and the high prevalence of hepatitis C virus (HCV) infection among patients on maintenance dialysis has been suggested to play a role. However, the impact of HCV on the immune response to HB vaccine in patients receiving long‐term dialysis is not entirely understood. Here, we evaluate the influence of HCV infection on the immunological response to HBV vaccine in dialysis population by performing a systematic review of the literature with a meta‐analysis of clinical studies.We used the random‐effects model of DerSimonian and Laird with heterogeneity and sensitivity analyses. The end‐point of interest was the rate of patients showing seroprotective anti‐hepatitis B titres at completion of HBV vaccine schedule among HCV‐positive versus HCV‐negative patients on chronic dialysis. We identified eight studies involving 520 unique patients on long‐term dialysis. Aggregation of study results did not show a significant decrease in response rates among HCV‐infected versus noninfected patients [pooled odds ratio = 0.621 (95% CI, 0.285; 1.353)]. The P ‐value was 0.007 for our test of study heterogeneity. Stratified analysis in various subgroups of interest did not meaningfully change our results. Our meta‐analysis showed no association between immunological response to hepatitis B vaccine and HCV infection in individuals on long‐term dialysis. These results support the use of recombinant vaccine against hepatitis B in patients on regular dialysis with HCV infection.