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김종진(Jong Jin Kim),문미경(Mi Kyoung Moon),임학(Hark Rim),김진규(Jin Kyoou Kim),박선자(Seon Ja Park),양상호(Sang Ho Yang),박상은(Sang Eun Park),이시래(Si Rhae Lee) 대한내과학회 1991 대한내과학회지 Vol.41 No.2
N/A The immune response to HB vaccination in ESRD patients has thus far been poor, but a better immune response is seen in patients who have been given reinforced vaccination. We measured anti-HBs seroconversion rates in a total of 100 ESRD patients (HD 60, CAPD 37, and transplantation 3 patients) who were vaccinated with Hepavax®. The results were as follows: 1) The anti-HBs seroconversion rate of 54 anti-HBc positive patients was 44.6%, and that of 46 anti-HBc negative patients 34.8%. 2) Anti-HBs seroconversion rates were 38.3% in the HD group, 43.2% in the CAPD group, and 33.3% in the renal transplantation group. 3) There was a lower anti-HBs seroconversion rate in the group under going a longer of dialysis: 44.4% in the group of less than 1 month period of dialysis and 9.1% in the group who had been on dialysis for 13 to 36 months. 4) Anti-HBs seroconversion rates were 39.1% in 40 ㎍, 3 times vaccination group, 45.6% in 20 ㎍, 3 times vaccination group, and 39.3% in 40 ㎍, 1 or 2 times vaccination group. The seroconverted patients in 40 ㎍, 3 times vaccination group revealed a higher titer and longer sustained anti-HBs in serum. However, anti-HBs seroconversion rates were not different in the 3 groups of various dosages. 5) An anti-HBc negative patient who had revealed low titer of anti-HBs after 3 doses of 20 ㎍, received a kindey transplantation from an HBsAg negative donor and developed acute viral hepatitis B in 10 months. Another anti-HBc positive patient, who had revealed a low titer of anti-HBs after 2 doses of 40 ㎍ but converted into anti-HBs negative in 5 months, showed a high titer of anti-HBs after receiving a renal transplantation from an HBsAg positive donor. These results show that reinforced doses of HB vaccine in ESRD patients were effective in developing a higher titer and longer duration of anti-HBs.