Hepatitis C virus and the immunological response to hepatitis B virus vaccine in dialysis patients: Meta-analysis of clinical studies

F. Fabrizi, V. Dixit, P. Martin, P. Messa

Research output: Contribution to journalArticlepeer-review


It is well known that the seroconversion rate of patients following hepatitis B virus (HBV) vaccination is lower in uraemic than healthy subjects. A variety of inherited or acquired factors have been implicated in this diminished response, and the high prevalence of hepatitis C virus (HCV) infection among patients on maintenance dialysis has been suggested to play a role. However, the impact of HCV on the immune response to HB vaccine in patients receiving long-term dialysis is not entirely understood. Here, we evaluate the influence of HCV infection on the immunological response to HBV vaccine in dialysis population by performing a systematic review of the literature with a meta-analysis of clinical studies.We used the random-effects model of DerSimonian and Laird with heterogeneity and sensitivity analyses. The end-point of interest was the rate of patients showing seroprotective anti-hepatitis B titres at completion of HBV vaccine schedule among HCV-positive versus HCV-negative patients on chronic dialysis. We identified eight studies involving 520 unique patients on long-term dialysis. Aggregation of study results did not show a significant decrease in response rates among HCV-infected versus noninfected patients [pooled odds ratio = 0.621 (95% CI, 0.285; 1.353)]. The P-value was 0.007 for our test of study heterogeneity. Stratified analysis in various subgroups of interest did not meaningfully change our results. Our meta-analysis showed no association between immunological response to hepatitis B vaccine and HCV infection in individuals on long-term dialysis. These results support the use of recombinant vaccine against hepatitis B in patients on regular dialysis with HCV infection.

Original languageEnglish
Pages (from-to)871-876
Number of pages6
JournalJournal of Viral Hepatitis
Issue number12
Publication statusPublished - Dec 2011


  • dialysis
  • hepatitis B virus
  • hepatitis C virus
  • meta-analysis
  • vaccine

ASJC Scopus subject areas

  • Hepatology
  • Infectious Diseases
  • Virology


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