Intramuscular and intradermal hepatitis B vaccine administration: immunological response in hemodialysis patients

Hepatitis B is a viral infection that may progress to cirrhosis and liver carcinoma. Its prevalence has been estimated at 4.9% among hemodialysis patients. The vaccine applied intramuscularly (IM) to end-stage kidney disease patients, often elicits inadequate antibody titers. Additionally, intradermal (ID) vaccine inoculation into healthy individuals and hemodialysis patients seems to be effective. The study compared the responses to the two vaccine application approaches, in patients initiating hemodialysis. Hemodialysis patients were randomized to receive either 40 micrograms/dose IM vaccine or 4 micrograms/dose ID vaccine at zero, 1 and 2 months. Patients were followed for 6 months with evaluation of titers of antibodies against hepatitis B surface antigen (anti-HBs).