Khalfaoui Mohamed Amine
C HU Ibn Rochd, Morocco
Title: Evolution of the rate of anti-Hbs antibodies after vaccination against hepatitis B in patients with renal insufficiency not on dialysis
Biography
Biography: Khalfaoui Mohamed Amine
Abstract
Introduction: The immunodeficiency, moderate in patients with chronic renal failure (IRC), explains a susceptibility greater to viral infections including viral hepatitis B, unfortunately these patients respond badly to vaccination against hepatitis B. In addition, their rate of Ac protectors decreases more rapidly than in the general population. We have studied the decay of the rate of Ac Hbs in renal failure chronic non-dialysis and vaccinated against hepatitis B. Patients and methods: We have measured the rate of Ac Hbs every 3 to 6 months in renal failure not on dialysis followed in consultation and having been vaccinated with success against hepatitis B (Ac Hbs>10 IU/ml). Result : Forty patients aged 48±11years, with creatinine clearance to 28±13ml/min which 57.5 per cent of men and 42.5 per cent of women have been followed on average 12 months (min 6 months/max 18 months). The initial nephropathy was a diabetic nephropathy in 18 patients (45 % ), the nephroangiosclerose 11 patients (27.5 % ), and finally of chronic glomerulonephrites in 7 patients (17.5 %) and 4 patients with an indeterminate nephropathy. The rate of Ac at the beginning of the follow-up was on average to 260 IU/ml . This rate declined by an average of 30 IU/ml per month. The threshold of 10 IU/ml below which patients are no longer protected was reached in 10 months on average. Among the factors studied (creatinine clearance, sex, weight, diabetes, baseline albumin, protidemie, type of nephropathy) none was predictive of the rate of reduction of the Ac. Discussion: The decrease in the rate of Ac HBS is fast among the IRC which makes necessary a serological monitoring regular all the more that nothing allows you to predict the speed of decay for a given patient. Our study allows giving an estimate of the rate of the monitoring and of the delay before a new vaccination in function of the initial rate of Ac. Conclusion: The renal disease loses their protection against hepatitis B in 12 months on average which makes the serological surveillance necessary.