Abstract: TH-PO1085
Rapid Serologic Response of Patients with Advanced CKD to HepB-CpG Vaccination
Session Information
- CKD Progression and Complications: Diagnosis, Prognosis, Risk Factors
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Yang, Christopher, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Bansal, Anip, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
Background
Vaccination against Hepatitis B virus (HBV) is recommended in patients with CKD who are at risk for progressive kidney disease due to risk from sporadic outbreaks in hemodialysis units. There are 3 recommended HBV vaccines available in the US: Recombivax-HB, Engerix-B and Heplisav-B (HepB-CpG). HepB-CpG has been reported to have improved immunogenicity, especially in groups known to have low responses historically e.g. patients with CKD and ESKD.
Methods
The following retrospective cohort study is an analysis of sero-response rates to HepB-CpG in the outpatient CKD clinic at the University of Colorado hospital. All patients with documented administration of at least one dose of HepB-CpG between January 1, 2021 to December 31, 2022 were included in this study.
Results
96 patients at our clinic received at least one dose of the HepB-CpG vaccine. Of these 96 patients, 67 patients had a follow-up hepatitis B surface antibody (HepBsAb) titer measured. Common reasons for non-measurement of follow up titers included death, start of kidney replacement therapy and loss to follow up. Of the 67 patients with measured follow up titers, there was an 80% (53/67) serologic response (HepBsAb > 10mIU/ml) after 1-3 doses of the vaccine (scheduled to be given at 0, 1 and 6 months). There was similar serologic response between CKD stages [CKD5: 22/27 (81%), CKD4: 22/27 (81%), CKD3b: 7/9 (77%), CKD1-CKD3a: 1/2 (50%)]. Only 2 of these patients required more than one series for a serologic response. Of the 14 non-responders who received at least two doses of the HepB-CpG vaccine, 6 patients were solid organ transplant recipients on immunosuppression (5 liver, 1 kidney), 2 patients had active multiple myeloma, and 2 patients had solid organ malignancies.
Conclusion
In our real world clinical experience, HepB-CpG produces a rapid serologic response in advanced CKD patients requiring less doses compared to the high dose of the traditional HBV vaccines (Engerix or Recombivax-HB). Ongoing immunosuppression and active malignancy were the common causes of response failure.