Immune response to a heat-inactivated hepatitis B vaccine in patients undergoing hemodialysis. Enhancement of the response by increasing the dose of hepatitis B surface antigen from 3 to 27 micrograms

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Abstract
In a randomized trial, 227 patients undergoing hemodialysis who were seronegative for all markers of hepatitis B virus were immunized at monthly intervals with 3 doses of either 3 .mu.g or 27 .mu.g of heat-inactivated hepatitis B HB-vaccine (CLB). Five mo. after the 1st injection, 77% of the patients in the 3-.mu.g group and 94% in the 27-.mu.g group manifested antibodies against hepatitis B surface antigen (anti-HB). At month 12 the proportions of subjects with anti-HB in the 3-.mu.g and 27-.mu.g groups had dropped to 68% and 87%, respectively. At all times, the differences in the anti-HB conversion rate between the 2 treatment groups were significant. The impaired immune reactivity to hepatitis B vaccines of patients undergoing hemodialysis can be overcome by increasing the dose of the vaccine.