Vaccine Response against Hepatitis B Virus in Patients with Chronic Kidney Failure Not on Dialysis and Factors Associated with Poor Response

Abstract

Objective : To study the vaccine response to the hepatitis B virus vaccine in patients with chronic kidney disease (CKD) and identify factors associated with poor vaccine response. Materials and Methods: This longitudinal and analytical study was conducted over a two-year period, from January 1, 2022, to December 31, 2023. The research was carried out in the nephrology outpatient department of Brazzaville University Hospital. All patients aged 18 years or older, of any sex, with stage 4 or 5 CKD—regardless of etiology—who provided informed consent were included. Results: A total of 61 consenting patients were enrolled in the study, comprising 42 men and 19 women, resulting in a sex ratio of 2.21. The mean age was 50.36 years ± 14.07, ranging from 21 to 79 years. The most prevalent comorbidities were hypertension (63.3%, n = 38), diabetes (39.3%, n = 24), obesity (26.2%, n = 16), and heart disease (24.5%, n = 15). Nearly 70% of patients exhibited a positive vaccine response, with 23% (n = 14) classified as good responders and 46% (n = 28) as poor responders. Among male participants, 74% (n = 31) were highly immunized. Chronic kidney disease (CKD) duration exceeding five years and CKD stage 5 were statistically associated with poor or absent vaccine response (p: 0.0195; p: 0.0150). Diabetes mellitus was the only comorbidity linked to poor or absent vaccine response (OR: 1.11 [0.34 - 3.59], p: 0.0615). Conclusion: A high rate of good vaccine response was observed in our study population. CKD duration exceeding 5 years and stage 5 CKD were associated with poor or absent response to vaccination. Diabetes mellitus was identified as the sole factor associated with poor vaccine response.