Seroprotection after hepatitis B vaccination in chronic kidney disease patients with modified schedule and dosage

Background: This study was conducted to determine the efficacy of four doses of 40 μg vaccine in chronic kidney disease patients as compared to the three-dose 20 μg vaccine schedule given to the normal healthy population. Methodology: This study included 130 chronic kidney disease patients. Of these 84 were given 20 μg vaccine (52 patients were given three doses at 0, one and two months, and 32 patients were given four doses at 0, one, two and six months) and 46 patients were given 40 μg vaccine (30 patients were given three doses at 0, one and two months and 16 patients were given four doses at 0, one, two and six months). Patient response was assessed by measuring antibodies to hepatitis B surface antigen (anti HBs) one month after receiving the third and fourth doses each. Results: Of the patient who received three doses of 20 μg vaccine, 57.7% showed seroprotection while 68.7% of the patients who received four doses of this vaccine showed seroprotection. In contrast, 60% of the patients who received three doses of 40 μg vaccine had seroprotective antibody titers while 87.5% of the patients receiving four doses of 40 μg vaccine showed seroprotection. Conclusions: Seroprotection after four doses of 40 μg vaccine at 0, one, two, and six months was found to be better and cost effective in chronic kidney disease patients compared to three doses of 20 μg vaccine given to normal healthy individuals with adequate renal function.