Duration of immunogenicity of high-dose and prolonged-schedule hepatitis B vaccine among patients with chronic kidney disease: A one year follow-up study in China

Background Patients with chronic kidney disease (CKD) have immunological defects that result in reduced production and faster decay of anti-HBs after hepatitis B vaccination. We assessed the duration of the immunogenicity after four-standard-dose and four-triple-dose regimens among patients with CKD. Methods A randomized controlled trial was conducted between May 2019 and February 2020. Patients were randomly allocated to receive three or four doses of 20 mu g , or four doses of 60 mu g of hepatitis B vaccine. Immunogenicity was assessed for 18 months till February 2021. Results Between months 7 and 18, the seroconversion rate decreased from 81.7% (58/71) to 64.3% (36/56) in IM20 x 3 group, from 93.0% (66/71) to 77.4% (41/53) in IM20 x 4 group, and from 93.2% (68/73) to 90.7% (49/54) in IM60 x 4 group. Seroconversion was higher in IM60 x 4 group than in IM20 x 3 group at month 18 (P < 0.05). In multivariate analysis, CKD patients without immune suppression or hormone therapy or patients with IM60 x 4 were more likely to have durable immunogenicity at month 18. Conclusions Patients receiving four-triple-dose regimen of hepatitis B vaccine showed improved duration of immunogenicity at the one-year follow-up.