[Effect of serum zinc levels on humoral immune response to hepatitis b vaccination in patients on dialysis]

ABSTRACT

Zinc deficiency causes abnormalities in immune response. In chronic hemodialysis [I-ID] and continuous ambulatory peritoneal dialysis [CAPD] patients, impaired immune responses to vaccination have been reported. Therefore, we performed a study to determine the correlation between serum zinc levels and immune response to hepatitis B vaccination in patients on dialysis. A cross-sectional study including 95 CRF patients on dialysis [70 HD and 25 CAPD], [63 male and 32 female] with three dose regimens of vaccination against HBV was performed. Four months after vaccination, there were 34 [36%] patients with sufficient HBs Antibody response [HBs Ab >/= 10 MU/mL] and 61[64%] patients with insufficient HBs antibody response[HBs Ab< 10mU/mL]. The mean serum zinc level was 23.35 +/- 3.87 micmol/L [13.20-33 micmol/L]. The mean serum zinc concentration was significantly higher in patients with sufficient HBs antibody level than patients with insufficient HBs antibody levels [24.94 +/- 4.17 versus 22.15 +/- 3.46, P= 0.005]. In logistic regression analysis, independent variables that correlated with sufficient HBs Ab level >/= 10 MU/mL included higher mean serum zinc level [OR=1.44 [1.02-2.02], P=0.006] and female gender [OR=1.8 [1.01-4.01], P=0.048]. Factors found to be insignificant included type of dialysis, age, diabetes mellitus as a cause of ESRD, serum creatinine and albumin levels. We conclude that failure to respond to HBV vaccination is significantly related to a low levels of serum zinc. However, clinical trial studies should be performed in order to confirm this finding: