Mansur KAYATAŞ, Can HÜZMELİ, Ayşe KOÇKARA ŞEKER, Ferhan CANDAN

Hemodiyaliz ve periton diyalizi hastalarının Hepatit B aşısına karşı cevaplarının karşılaştırılması

Kronik böbrek hastalığı (KBH) olan hastaların çoğunda hem humoral hem de hücresel immünitedeyetersizlik söz konusudur. Bu çalışmada KBH hastalarında çift doz rekombinant hepatit B aşısınakarşı yanıt oranları ve renal replasman türünün antikor oluşumunda etkisi araştırılmıştır.Cumhuriyet Üniversitesi Tıp Fakültesi Hastanesi diyaliz merkezinde 51 hemodiyaliz (HD), 19sürekli ayaktan periton diyalizi (SAPD) hastası rekombinant hepatit B aşısı ile 0,1,2 ve 6. aydatoplam dört kez aşılandı. Antikor yanıtları Anti-HBs titrasyon düzeylerine göre belirlendi. Aşınınson dozundan 1-3 ay sonra bakılan 10 mIU/mLnin üstündeki antikor titreleri aşıya yanıt olarakkabul edildi. Sonuçta HD ve SAPD hastalarının hepatit B aşısına verdikleri yanıtlar arasındaanlamlı bir fark görülmedi (SAPD hastalarında %84,2, HD hastalarında %78,4 , p=0,591). Diyalizsüresinin, cinsiyetin, yaşın, hemoglobin, total protein, albümin, c-reaktif protein (CRP), totalkolesterol, trigliserid düzeyinin ve Anti-HCV(+)liğinin hepatit B serokonversiyonuna etkisi dedeğerlendirildi. Bunlar arasında sadece yaşın >50 (yıl) olmasının yetersiz hepatit Bserokonversiyonu ile ilişkili olduğu görüldü (p=0,037). Diğer parametrelerin hepatit Bserokonversiyonu üzerine etkisi gösterilemedi (p>0,05).

Comparison of responses to Hepatitis B vaccine in patients with hemodialysis and peritoneal dialysis

There is generally a failure in humoral and cellular immunity in most of the patients with chronicrenal failure (CRF). In this study, the rate of response of CRF patients to a double-dose hepatitisvaccination and the effect of renal replacement type on the formation of antibodies have beeninvestigated. In our centre, 51 hemodialysis (HD) and 19 continuous ambulatory peritonealdialysis (CAPD) patients were vaccinated with recombinant hepatitis B in the 0th, 1st, 2nd and 6thmonths. Antibody titrates over 10 mIU/ml seen 1-3 months after the vaccination were consideredas a response to the vaccine. As a result, no meaningful difference has been observed between theresponses HD and CAPD patients gave to the vaccine (CAPD 84.2%, HD 78.4%, p=0.591). Theeffects of the duration of the dialysis, sex, age and hemoglobin, total protein, albumin, c-reactiveprotein (CRP), total cholesterol and triglyceride levels and the positivity of anti-HCV on hepatitisB seroconversion have also been evaluated. Of all these, only the age being over 50 has been seento have a relationship with insufficient hepatitis B ceroconversion (p=0.037). The other parameterscouldn t be shown to have an effect on the hepatitis B seroconversion (p> 0.05).

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