Vaccination against hepatitis B virus in hemodialysis patients: trends in dialysis centers of Northern Pakistan

Abstract

Background: Chronic kidney disease (CKD) patients, especially those on hemodialysis, are at increased risk of developing hepatitis B virus (HBV) infection. Guidelines suggest that all patients with CKD should be vaccinated against HBV, but these guidelines are usually not followed. We conducted this study to know the status of vaccination against HBV in CKD patients on regular hemodialysis. Methods: This observational descriptive study was conducted at the Department of Medicine, Sheikh Khalifa Bin Zayed Teaching Hospital, Poonch Medical College Rawalakot , and POF Teaching Hospital, Wah Medical College Wah Cantt, from March to July 2019. Patients reporting to the dialysis center of both hospitals on regular dialysis were included in the study. Patient information (HBV vaccination status, age, gender, education, socioeconomic status, duration of CKD and duration of dialysis) were collected on a specially designed questionnaire. The statistical analysis of data was done in SPSS for Windows, version 20. Results: A total 149 patients were included in the study, 63.1% were male and 36.9% were female. Out of these 24.2% were uneducated, 33.6% had 1-10 years school education, 38.2% had 10-14 years education, and 4% had more than 14 years education. About 35% patients were from low socioeconomic class, 54% from middle and 11% from higher class. Only 45.6% (n=68) of patients were vaccinated and 54.4% (n=81) were not vaccinated against HBV. Vaccination status was significantly associated with education (p=0.004) and socioeconomic status (p=0.008). Conclusion: The HBV status of patients on regular hemodialysis is not satisfactory at the two centers observed. It is associated with education and socioeconomic status of the patient.