A Randomized Controlled Trial of Two Schedules of Hepatitis B Vaccination in Predialysed Chronic Renal Failure Patients

Background: Patients with chronic renal disease should be vaccinated as soon as dialysisis forestalled, and this could improve the seroconversion of hepatitis B vaccination.Objectives: In this study, we aimed to compare seroconversion and immune responserates using 4 doses of 40 µg and 3 doses of 20 µg Euvax B recombinant Hepatitis B surfaceAntigen (HBs Ag) vaccine administered to predialysis patients with chronic kidneydisease (CKD).Patients and Methods: In an open, randomized clinical trial, we compared seroconversionrates in 51 predialysis patients with mild and moderate chronic renal failure whoreceived either 4 doses of 40 µg or 3 doses of 20 µg of Euvax B recombinant hepatitis Bvaccine administered at 0, 1, 2, 6 and 0, 1, 6 months, respectively.Results: Differences in seroconversion rates after 4 doses of 40 µg (80.88%) comparedto 3 doses of 20 µg (92%) were not significant (P = 0.4124). The mean HBs antibody levelafter 4 doses of 40 µg at 0, 1, 2, and 6 months (182.2 ± 286.7) was significantly higher thanthat after 3 doses of 40 µg at 0,1, and 6 months (96.9 ± 192.1) (P = 0.004). Seroconversionafter 4 doses of 40 µg (80.8%) was also significantly higher than that after 3 doses of 40 µg(77%) (P = 0.004). Multivariable analysis showed that none of the variables contributedto seroconversion.Conclusions: We found that 4 doses of 40 µg did not lead to significantly more seroconversionthan 3 doses of 20 µg.