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

<b>Background:</b> 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 chronic kidney disease CKD should be vaccinated against Hepatitis HBVB, but these guidelines are usually not followed. We conducted this study to know the status of vaccination against HBV in chronic kidney disease patients on regular hemodialysis. <b>Methods: </b>This observational descriptive study was conducted at the Department of Medicine, Sheikh Khalifa Bin Zayed Teaching Hospital, Poonch Medical College Rawalakot , and POF Teaching Hhospital, Wah Medical College Wah Cantt, from March 2019 to July 2019. Patients reporting to the dialysis center of both hospitals on regular dialysis were included in the study. Patient’s information (like HBV vaccination status, age, gender, education, socioeconomic status and duration CKD), were collected on a specially designed form. The statistical analysis of data was done in SPSS for Windows, version 20. <b>Results:</b> 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 associated with education (p=0.004) and socioeconomic status (p=0.008). <b>Conclusion</b>: The Hepatitis B vaccination 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.

背景：慢性肾脏病（Chronic Kidney Disease, CKD）患者，尤其是接受血液透析的人群，感染乙型肝炎病毒（Hepatitis B Virus, HBV）的风险显著升高。临床指南建议所有慢性肾脏病患者均应接种乙型肝炎病毒疫苗，但此类指南的实际依从性普遍欠佳。本研究旨在调研规律血液透析的慢性肾脏病患者的乙型肝炎病毒疫苗接种现状。
方法：本研究为观察性描述性研究，于2019年3月至2019年7月期间，在蓬奇医学院拉瓦拉科特分校谢赫·哈利法·本·扎耶德教学医院、瓦赫坎特瓦赫医学院POF教学医院的内科开展。本研究纳入两所医院透析中心规律接受血液透析的患者。研究人员通过特制的调查问卷收集患者的相关信息，包括乙型肝炎病毒疫苗接种状态、年龄、性别、受教育程度、社会经济地位以及慢性肾脏病病程。数据统计分析采用Windows版SPSS 20.0软件完成。
结果：本研究共纳入149例患者，其中男性占63.1%，女性占36.9%。受教育程度方面，24.2%的患者未接受过任何正规教育，33.6%的患者受教育年限为1~10年，38.2%为10~14年，仅4%的患者受教育年限超过14年。社会经济地位方面，约35%的患者属于低收入阶层，54%属于中等收入阶层，11%属于高收入阶层。仅45.6%（n=68）的患者完成了乙型肝炎病毒疫苗接种，54.4%（n=81）未接种该疫苗。疫苗接种状态与患者的受教育程度（p=0.004）及社会经济地位（p=0.008）显著相关。
结论：本次调研的两所中心中，规律血液透析患者的乙型肝炎病毒疫苗接种现状并不理想，且该现状与患者的受教育程度及社会经济地位密切相关。