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Abstract：
BACKGROUND: Hepatitis B infection is one of the most common infections worldwide, with its vaccination being an effective preventive measure. Nonresponse to hepatitis B vaccination increases population susceptibility to virus dissemination along with detrimental complications. Despite twice intramuscular vaccination series, 14.3% in the general population and 50% in hemodialysis patients fail to mount a response against hepatitis B. We aimed to evaluate the effectiveness of intradermal (ID) vaccination in the nonresponders amongst the general and hemodialysis population.
METHODS: A total of 5 doses of 10 μg of hepatitis B vaccine was given intradermally, 2 weeks apart, to both the study groups: patients who were on hemodialysis and the general population group who previously had failed to achieve satisfactory antibody titers with the IM administration of the vaccine. A hepatitis B surface antibody (HBsAb) titer of ≥10 IU/mL and ≥100 IU/mL were considered \"responder\" and \"good responder,\" respectively.
RESULTS: Out of a total of 95 participants, 49 (51.6%) were hemodialysis-dependent. Most of the participants were females 49 (51.6%). The mean age of all the participants was 39.02 ± 13.5 years (range: 18-70 years). Overall, 75.8% of the participants responded to the ID vaccination with a mean HBsAb titer of 263.5 ± 350.1 IU/L. Almost similar vaccination response was observed in both the hemodialysis and general population i.e., 75.5% and 76.1%, respectively (P = 1.00). In the hemodialysis group, the absence of hypertension (P = 0.04) and age ≥36 years (P = 0.016) were associated with an ID vaccination response.
CONCLUSIONS: For those not responding to the conventional IM route of the hepatitis B vaccine, the ID route is an effective way of immunization in this group and this approach would lead to a decrease in infection rates in the vulnerable population such as those on hemodialysis.
METHODS: A total of 5 doses of 10 μg of hepatitis B vaccine was given intradermally, 2 weeks apart, to both the study groups: patients who were on hemodialysis and the general population group who previously had failed to achieve satisfactory antibody titers with the IM administration of the vaccine. A hepatitis B surface antibody (HBsAb) titer of ≥10 IU/mL and ≥100 IU/mL were considered \"responder\" and \"good responder,\" respectively.
RESULTS: Out of a total of 95 participants, 49 (51.6%) were hemodialysis-dependent. Most of the participants were females 49 (51.6%). The mean age of all the participants was 39.02 ± 13.5 years (range: 18-70 years). Overall, 75.8% of the participants responded to the ID vaccination with a mean HBsAb titer of 263.5 ± 350.1 IU/L. Almost similar vaccination response was observed in both the hemodialysis and general population i.e., 75.5% and 76.1%, respectively (P = 1.00). In the hemodialysis group, the absence of hypertension (P = 0.04) and age ≥36 years (P = 0.016) were associated with an ID vaccination response.
CONCLUSIONS: For those not responding to the conventional IM route of the hepatitis B vaccine, the ID route is an effective way of immunization in this group and this approach would lead to a decrease in infection rates in the vulnerable population such as those on hemodialysis.
摘要：
背景：乙型肝炎感染是全球最常见的感染之一，疫苗接种是一种有效的预防措施。对乙型肝炎疫苗接种的无应答增加了人群对病毒传播的易感性以及有害的并发症。尽管两次肌肉注射疫苗系列，在一般人群中14.3％和血液透析患者中50％未能对乙型肝炎产生反应。我们旨在评估在一般和血液透析人群中无反应者的皮内（ID）疫苗接种的有效性。
方法：皮内给予共5剂10μg乙肝疫苗，相隔两周,这两个研究组:接受血液透析的患者和以前通过IM接种疫苗未能达到令人满意的抗体滴度的普通人群组.乙肝表面抗体（HBsAb）滴度≥10IU/mL和≥100IU/mL被认为是“应答者”和“良好应答者，\"分别。
结果：在总共95名参与者中，49（51.6％）是血液透析依赖性。大多数参与者是女性49（51.6％）。所有参与者的平均年龄为39.02±13.5岁（范围：18-70岁）。总的来说,75.8％的参与者对ID疫苗接种有反应，平均HBsAb滴度为263.5±350.1IU/L。在血液透析和普通人群中观察到几乎相似的疫苗接种反应，即75.5%和76.1%，分别(P=1.00)。在血液透析组,无高血压(P=0.04)和年龄≥36岁(P=0.016)与ID疫苗接种应答相关.
结论：对于那些对乙肝疫苗的常规IM途径没有反应的人，在该组中,ID途径是一种有效的免疫方法,这种方法将导致脆弱人群如血液透析人群的感染率降低.
方法：皮内给予共5剂10μg乙肝疫苗，相隔两周,这两个研究组:接受血液透析的患者和以前通过IM接种疫苗未能达到令人满意的抗体滴度的普通人群组.乙肝表面抗体（HBsAb）滴度≥10IU/mL和≥100IU/mL被认为是“应答者”和“良好应答者，\"分别。
结果：在总共95名参与者中，49（51.6％）是血液透析依赖性。大多数参与者是女性49（51.6％）。所有参与者的平均年龄为39.02±13.5岁（范围：18-70岁）。总的来说,75.8％的参与者对ID疫苗接种有反应，平均HBsAb滴度为263.5±350.1IU/L。在血液透析和普通人群中观察到几乎相似的疫苗接种反应，即75.5%和76.1%，分别(P=1.00)。在血液透析组,无高血压(P=0.04)和年龄≥36岁(P=0.016)与ID疫苗接种应答相关.
结论：对于那些对乙肝疫苗的常规IM途径没有反应的人，在该组中,ID途径是一种有效的免疫方法,这种方法将导致脆弱人群如血液透析人群的感染率降低.
