Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Zitt, E; Hafner-Giessauf, H; Wimmer, B; Herr, A; Horn, S; Friedl, C; Sprenger-Mähr, H; Kramar, R; Rosenkranz, AR; Lhotta, K.
Response to active hepatitis B vaccination and mortality in incident dialysis patients.
Vaccine. 2017; 35(5):814-820
Doi: 10.1016/j.vaccine.2016.12.032
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- Führende Autor*innen der Med Uni Graz
- Hafner-Giessauf Hildegard Elisabeth
- Rosenkranz Alexander
- Co-Autor*innen der Med Uni Graz
- Horn Sabine
- Lackner Claudia
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- Abstract:
- All patients with advanced chronic kidney disease or on renal replacement therapy should receive active hepatitis B vaccination. The aim of this retrospective cohort study was to investigate the association between the immune response to hepatitis B vaccination and all-cause, cardiovascular or infection-related mortality in incident dialysis patients starting dialysis between 2001 and 2008 (n=426) in two Austrian dialysis centers. Vaccination response was defined as follows: absent anti-HBs antibody titer or a titer <10IU/L was classified as non-response, seroconversion (SC) was defined as a titer ⩾10IU/L, and seroprotection (SP) as a titer ⩾100IU/L. Kaplan-Meier survival curves and multivariable adjusted Cox Proportional Hazards Models were used to determine the association between vaccination response and all-cause, cardiovascular and infection-related mortality. Of all patients 207 (48.6%) were non-responders, SC was observed in 219 (51.4%), SP in 118 (27.7%) patients. During a median follow-up of 51.2 months 228 (53.5%) patients died. Patients with SP and SC showed a significantly lower all-cause (p<0.001 for both) and cardiovascular mortality (p=0.006 for SP, p=0.01 for SC). SP and SC were independently associated with a significant risk reduction for all-cause mortality (SP: HR 0.69, 95% CI 0.49-0.97, p=0.03; SC: HR 0.72, 95% CI 0.55-0.95, p=0.02). In conclusion, achieving seroconversion and seroprotection after active hepatitis B vaccination is associated with significantly reduced all-cause mortality in incident dialysis patients. This simple and readily available tool allows estimation of patient survival independently of other well-known key parameters such as age, gender, the presence of diabetes and markers of malnutrition and inflammation. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Female -
- Hepatitis B - immunology
- Hepatitis B - mortality
- Hepatitis B - prevention & control
- Hepatitis B - virology
- Hepatitis B Antibodies - biosynthesis
- Hepatitis B Vaccines - administration & dosage
- Hepatitis B virus - drug effects
- Hepatitis B virus - immunology
- Humans -
- Kaplan-Meier Estimate -
- Male -
- Middle Aged -
- Proportional Hazards Models -
- Renal Dialysis -
- Renal Insufficiency, Chronic - mortality
- Renal Insufficiency, Chronic - pathology
- Renal Insufficiency, Chronic - physiopathology
- Renal Insufficiency, Chronic - therapy
- Retrospective Studies -
- Vaccination -
- Find related publications in this database (Keywords)
- Dialysis
- Hepatitis B
- Hepatitis B vaccination
- Mortality