Immune Response to Hepatitis B Vaccine in Patients with Chronic Kidney Disease

Despite the use of hepatitis B virus (HBV) vaccines and preventive measures, infection with HBV remains a major global health problem. Patients with chronic kidney disease (CKD) are at an increased risk of acquiring HBV infections from shared dialysis equipment, increased exposure to blood products, and immunodeficiency associated with CKD (1, 2). In addition, they may be more likely to develop chronic infections on exposure to HBV (1, 2), and HBV infection among CKD patients is associated with high rates of morbidity and mortality (3, 4). Vaccination is important both for preventing susceptible patients from acquiring HBV and for reducing the pool of HBVinfected patients. HBV infection remains a concern in dialysis populations, because the vaccination programs have been less successful in these populations than in the general population. The causes of poor seroconversion in CKD patients include malnutrition, uremia, and immunosuppression due to renal failure (5). In the current issue of Hepatitis Monthly, Behnam Hashemi et al. (6) compared the seroconversion rates of patients with different stages of CKD who received the HBV vaccine. The overall seroconversion rate was found