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World J Gastroenterol. Sep 14, 2014; 20(34): 12018-12025
Published online Sep 14, 2014. doi: 10.3748/wjg.v20.i34.12018
Factors affecting effectiveness of vaccination against hepatitis B virus in hemodialysis patients
Theodoros Eleftheriadis, Georgios Pissas, Georgia Antoniadi, Vassilios Liakopoulos, Ioannis Stefanidis
Theodoros Eleftheriadis, Georgios Pissas, Georgia Antoniadi, Vassilios Liakopoulos, Ioannis Stefanidis, Department of Nephrology, Medical School, University of Thessaly, 41110 Larissa, Greece
Author contributions: Eleftheriadis T, Pissas G, Antoniadi G, Liakopoulos V and Stefanidis I were responsible for review the literature and initial preparation of the manuscript; Eleftheriadis T prepared the final version of the manuscript.
Correspondence to: Theodoros Eleftheriadis, MD, PhD, Department of Nephrology, Medical School, University of Thessaly, Neo Ktirio, Mezourlo Hill, 41110 Larissa, Greece. teleftheriadis@yahoo.com
Telephone: +30-24-13501668 Fax: +30-24-13500242
Received: October 27, 2013
Revised: January 29, 2014
Accepted: April 8, 2014
Published online: September 14, 2014
Abstract

Hepatitis B virus (HBV) is a major global health problem. Despite the success of the general measures against blood transmitted infections in hemodialysis (HD) units, the prevalence of HBV infection among the HD patients is still high. Thus vaccination against HBV is indicating in this population. However, compared with the general population the seroprotection achieved in HD patients remains relatively low, at about 70%. In this review patient, HD procedure and vaccine-associated factors that affect the efficacy of HBV vaccination are analyzed. Also alternative routes of HBV vaccine administration as well as new and more immunogenic vaccine formulations are discussed. However, besides scientific progress, vigilance of HD physicians and staff regarding the general measures against the transmission of blood borne infections and the vaccination against HBV is also required for reducing the prevalence of this viral infection.

Keywords: Hemodialysis, Hepatitis B virus epidemiology, Hepatitis B virus vaccine, Adjuvant, Immunostimulant, Intradermal

Core tip: The prevalence of hepatitis B virus (HBV) infection among the hemodialysis (HD) patients is still high. Although vaccination against HBV has became a necessity in this population, the seroprotection achieved in HD patients remains relatively low. In this review patient, HD procedure and vaccine-associated factors that affect the efficacy of HBV vaccination are analyzed. The alternative routes of HBV vaccine administration as well as new and more immunogenic vaccine formulations are discussed with a detailed view of the protocols that increase HBV vaccination efficacy.