Immunogenicity and immunization costs of adjuvanted versus non-adjuvanted hepatitis B vaccine in chronic kidney disease patients

Figures & data

Table 1. Immunogenic response after the third dose of hepatitis B vaccine was administered in patients with chronic kidney disease.

	HBVAXPRO®				ENGERIX-B®				FENDRIX®				Vaccined population
	Total		Anti-HBs ≥ 10		Total		Anti-HBs ≥ 10		Total		Anti-HBs ≥ 10		Overall		Anti-HBs ≥ 10		p-value
	n	(%)^*	n	(%)^**	n	(%)^*	n	(%)^**	n	(%)^*	n	(%)^**	n	(%)^*	n	(%)^**
Overall	152	(100)	70	(46.1)	56	(100)	25	(44.6)	59	(100)	43	(72.9)	267	(100)	138	(51.7)
95% CI			(38.1–54.0)				(31.6–57.7)				(61.5–84.2)				(45.7–57.7)
Sex
Female	49	(32.2)	19	(38.8)	24	(42.9)	11	(45.8)	26	(44.1)	20	(76.9)	99	(37.1)	50	(50.5)	0.767
Male	103	(67.8)	51	(49.5)	32	(57.1)	14	(43.8)	33	(55.9)	23	(69.7)	168	(62.9)	88	(52.4)
Age (years)
18–44	9	(5.9)	4	(44.4)	2	(3.6)	2	(100)	5	(8.5)	4	(80.0)	16	(6.0)	10	(62.5)	0.001
45–64	47	(30.9)	31	(66.0)	20	(35.7)	11	(55.0)	13	(22.0)	12	(92.3)	80	(30.0)	54	(67.5)
≥65	96	(63.2)	35	(36.5)	34	(60.7)	12	(35.3)	41	(69.5)	27	(65.9)	171	(64.0)	74	(43.3)
Creatinine (mg/dL)
< 2	24	(15.8)	12	(50.0)	16	(28.6)	5	(31.3)	4	(6.8)	3	(75.0)	44	(16.5)	20	(45.5)	0.620
2–4	77	(50.7)	36	(46.8)	29	(51.8)	15	(51.7)	37	(62.7)	26	(70.3)	143	(53.6)	77	(53.8)
> 4	51	(33.6)	22	(43.1)	11	(19.6)	5	(45.5)	18	(30.5)	14	(77.8)	80	(30.0)	41	(51.3)
Immunocompromised
Yes	9	(5.9)	4	(44.4)	9	(16.1)	4	(44.4)	2	(3.4)	1	(50.0)	20	(7.5)	8	(45.0)	0.836
No	143	(94.1)	66	(46.2)	47	(83.9)	21	(44.7)	57	(96.6)	43	(73.7)	247	(92.5)	129	(52.2)
Hemodialysis
Yes	21	(14.5)	11	(52.4)	8	(14.8)	3	(37.5)	4	(6.8)	3	(75.0)	33	(12.8)	17	(51.5)	0.965
No	124	(85.5)	54	(43.5)	46	(85.2)	21	(45.7)	55	(93.2)	40	(72.7)	225	(87.2)	115	(51.1)

p-value = chi-square test of distribution of total vaccinated population

* = columns percentage

** = row percentage, values of non acceptable immunogenicity (Anti-HBs < 10 UI/mL) were omitted.

95% CI= confidence interval 95% of the proportion of acceptable immunogenicity to each vaccine (Anti-HBs ≥ 10 UI/mL).

= chi-square test of distribution of total vaccinated population.

Table 2. Factors potentially associated with an immunogenic response after hepatitis B immunization in patients with chronic kidney disease.

	OR	(95% CI)	p-value	ORa	(95% CI)
Sex
Female	1	–
Male	1.12	(0.71–1.79)	0.767
Age (years)
< 65	1	–		1	–
≥ 65	0.38	(0.23–0.64)	< 0.001	0.35	(0.21–0.60)
Creatinine (mg/dL)
< 2	1	–
2–4	1.38	(0.72–2.83)	0.364
> 4	1.32	(0.57–2.61)
Immunocompromised
No	1	–
Yes	0.71	(0.33–1.87)	0.534
Hemodialysis
No	1	–
Yes	1.02	(0.54–2.12)	0.965
Hepatitis B Vaccine
non-adjuvanted^†	1	–		1	–
adjuvanted	3.24	(1.66–5.97)	<0.001	3.56	(1.84–6.85)

OR: odds ratio.

ORa: odds ratio adjusted by multiple logistic regression model

† = HBVAXPRO and Engerix-B were grouped together

p-value= chi-square test

Figure 1. Decision tree and associated costs for each HBV vaccine. p1, p2 and p3 = immunogenicity of HBAXPRO, Engerix-B and Fendrix, respectively.

Figure 2. One way sensitivity analysis on Fendrix® price per dose vs. costs associated with other vaccines.