Evaluation of vaccination status and immune response against Hepatitis B Virus in chronic hemodialysis patients in Marrakech

Introduction: End-stage renal disease patients treated with maintenance hemodialysis are highly vulnerable to hepatitis B virus (HBV) transmission. Due to uremia, both cellular and humoral immunity are significantly impaired, making vaccination essential yet variably effective. This study aims to determine the post-vaccination seroprotection rate in our facility and analyze clinical and biochemical determinants of non-response.
Materials and Methods: A descriptive cross-sectional observational study was conducted on 110 stable end-stage renal disease patients on regular hemodialysis at the Nephrology Department of the Mohamed VI University Hospital in Marrakech. Serum quantification of anti-HBs antibodies was performed using microparticle chemiluminescence immunoassay (CMIA technique, Architect Abbott USA) following the completion of a full double-dose primary vaccination protocol initiated at entry into dialysis.
Results: The mean age of the cohort was 53.45 ± 15.4 years (range: 17–93 years), with a strong male predominance (sex ratio M/F = 1.70). The overall anti-HBs immunization rate reached 88%. A strong immune response (titer > 100 IU/l) was documented in 52% of subjects (n=57). Moderate seroprotection (titer between 10 and 100 IU/l) was observed in 36% (n=40). Finally, a complete absence of response (titer < 10 IU/l) was recorded in 12% of cases (n=13).
Discussion and Conclusion: Although vaccine coverage confers satisfactory protection to the majority of hemodialysis patients, an age older than 65 years, severe hypoalbuminemia, and profound vitamin D3 deficiency represent primary predictive factors for seroconversion failure. It is imperative to initiate anti-HBV vaccination early at the pre-terminal chronic kidney disease stage to optimize the immune profile before starting renal replacement therapy.