Meta-Analysis
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Jan 6, 2016; 5(1): 115-124
Published online Jan 6, 2016. doi: 10.5527/wjn.v5.i1.115
Sex bias in response to hepatitis B vaccination in end-stage renal disease patients: Meta-analysis
Hossein Khedmat, Aghdas Aghaei, Mohammad Ebrahim Ghamar-Chehreh, Shahram Agah
Hossein Khedmat, Aghdas Aghaei, Mohammad Ebrahim Ghamar-Chehreh, Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences, Tehran 14155-3651, Iran
Shahram Agah, Colorectal Research Center, Iran University of Medical Sciences, Tehran 19979-97653, Iran
Author contributions: Khedmat H prepared the manuscript; Aghaei A helped with database preparation; Ghamar-Chehreh ME helped with literature search; Agah S designed the study; all the authors helped with the finalization of the manuscript and wherever else their help was needed.
Supported by Grant from the Baqiyatallah University of Medical Sciences.
Conflict-of-interest statement: None.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mohammad Ebrahim Ghamar-Chehreh, MD, Assistant Professor, Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences, MullaSadra Street, Tehran 14155-3651, Iran. ghamarchehreh@gmail.com
Telephone: +98-21-88934125 Fax: +98-21-88934125
Received: February 3, 2015
Peer-review started: February 4, 2015
First decision: March 11, 2015
Revised: October 30, 2015
Accepted: December 4, 2015
Article in press: December 8, 2015
Published online: January 6, 2016
Processing time: 337 Days and 7 Hours
Abstract

AIM: To systematically review the literature for studies investigating the potential effect of gender of dialysis patients on the immunogenicity of hepatitis B virus vaccines.

METHODS: Literature searches were conducted by the MEDLINE and Google Scholar. The key words used included “hepatitis B (HB)”, “vaccine”, “dialysis”, “hemodialysis”, “sex”, “male” and “female”. Data of seroresponse to HB vaccine in clinical trials regarding sex of the recipients have been achieved and analyzed. Finally data from 19 clinical trials have been pooled and analyzed.

RESULTS: Analysis of response to HB vaccination in our dialysis population showed males significantly respond less to hepatitis B vaccination (P = 0.002, Z = 3.08) with no significant heterogeneity detected [P = 0.766; heterogeneity χ2 = 14.30 (df = 19); I2 = 0%]. A reanalysis of the pooled data was conducted regarding the dialysis mode to evaluate potential differential impact of sex on HB vaccine response. Hemodialysis was the only subgroup that showed a significant difference regarding dialysis mode in response to HB vaccination regarding sex (P = 0.042, Z = 2.03).

CONCLUSION: This Meta-analysis showed significant effect for the sex of chronic kidney disease and dialysis patients on the immunogenicity of HB vaccine. This sex discrimination was most prominent among hemodialysis patients.

Keywords: Hepatitis B virus vaccination; Hepatitis B virus; Immunogenicity; Dialysis patients; Gender; Sex

Core tip: This study showed that gender of the dialysis patients is a significant factor affecting serresponse to hepatitis B vaccination (HBV) in the immunocompromised population of hemodialysis population. This gender bias was most significantly prominent when patients were under hemodialysis (vs other renal replacement therapies including peritoneal dialysis). The relevance of such a finding is to enable the practitioners to be alerted on the effects of HBV vaccinations in dialysis patients and give them clues to individualize vaccination protocols for patients with specific epidemiological characters.