Prevalence of Hepatitis B Virus Antibody Levels Seroconversion in Patients on Hemodialysis: Mexican Cohort at Medica Santa Carmen

Background: Chronic Hemodialysis (HD) patients (px) are immunocompromised and hepatitis B virus (HBV) infection is a major concern due to increased susceptibility and poor vaccine response. Current recommendation related to HBV is to give vaccines during stage 5 in order to reach immunization and generate protective antibody levels of HBV (HbsAb). In Mexico, international HBV vaccination schedules for HD px are not necessarily accomplished (three double doses of 20 mcg/1ml for 6 months) and HbsAb are below what is desirable. Methods: We reviewed 1,967 HD px in Medica Santa Carmen kidney network and the main objective was to analyze seroconversion status with HbsAb over 10 mUI/ml. Vaccination status was uncertain for most px. Median, interquartile range and proportions were estimated. We compared groups with Man-Whitney U-test and chi square test. A regression model adjusted for significant variables was performed. Results: Seroconversion with HbsAb over 10 mUI/ml and 100 mUI/ml were 39% (760px) and 25% (487px) respectively. Comparative results by dividing HbsAb ≥10 vs HbsAb <10 mUI/ml groups are shown in the table. Significant differences were found in the HbsAb ≥10 mUI/ml group related to lower percentage of diabetes, hypertension, smoking and ischemic cardiopathy. In a multivariate analysis, age (OR 0.977, IC 0.970-0.984) and HD vintage (OR 1.004, IC 1.004-1.009) were statistically significant for seroconvertion status. Conclusion: In Mexico, individuals with protective levels of HbsAb is scarce. Immunized against the HBV group had lower weight, BMI and higher Kt/v. Younger patients and vintage in HD are related to better chances of being immunized. Funding: Clinical Revenue Support