摘要
Impaired renal function is associated with a high risk of chronicity of hepatitis B virus(HBV) infection.Patients on hemodialysis(HD) or peritoneal dialysis are at an increased risk of viral transmission due to frequent necessity of blood product transfer as well as use of contaminated dialysate or dialysis materials.Additionally,health professionals may cause viral spread via contaminated hands and carelessness against hygiene rules.The frequency of chronic HBV infection may be as high as 80% in patients on renal replacement therapies.This is because HBV vaccination is essential to eliminate chronic HBV infection.However,response rates of HD patients to HBV vaccination vary between 10%-50%.Dialysis adequacy and early vaccination before the onset of dialysis therapy seem to be major determinants of high seroconversion rates.Older age,male gender,duration of dialysis therapy and nutritional status are other well-known factors associated with seroconversion rate.There are controversial reports regarding the role of the presence of diabetes mellitus,HCV positivity,erythropoietin resistance,hyperparathyroidism,and vitamin D inadequacy.The role of genetic alteration in the functions or production of cytokines still needs to be elucidated.
Impaired renal function is associated with a high risk ofchronicity of hepatitis B virus （HBV） infection. Patientson hemodialysis （HD） or peritoneal dialysis are at anincreased risk of viral transmission due to frequentnecessity of blood product transfer as well as use ofcontaminated dialysate or dialysis materials. Additionally,health professionals may cause viral spread via contaminatedhands and carelessness against hygienerules. The frequency of chronic HBV infection may be ashigh as 80% in patients on renal replacement therapies.This is because HBV vaccination is essential to eliminatechronic HBV infection. However, response rates of HDpatients to HBV vaccination vary between 10%-50%.Dialysis adequacy and early vaccination before theonset of dialysis therapy seem to be major determinantsof high seroconversion rates. Older age, male gender,duration of dialysis therapy and nutritional status areother well-known factors associated with seroconversionrate. There are controversial reports regarding the roleof the presence of diabetes mellitus, HCV positivity,erythropoietin resistance, hyperparathyroidism, andvitamin D inadequacy. The role of genetic alteration inthe functions or production of cytokines still needs to beelucidated.
