The association between HLA-B40, HLA-DQA1*01 and HLA-DQB1*05 alleles and antibody response to hepatitis B vaccination in turkish hemodialysis patients

  • Gürsel Ersan Department of Infectious Diseases and Clinical Microbiology, Izmir Tepecik Training and Research Hospital, Health Sciences University, Izmir
  • Sibel Ersan Department of Nephrology, Izmir Tepecik Training and Research Hospital, Health Sciences University, Izmir
  • Tülay Kılıcaslan Ayna Department of Medical Biology and Genetics, Izmir Tepecik Training and Research Hospital, Health Sciences University, Izmir
Keywords: hemodialysis, hepatitis B vaccine, human leukocyte antigens, immune response

Abstract

Introduction: Hepatitis B virus (HepB) infection is a global health problem with increasing cause of morbidity and mortality. Hemodialysis patients are especially vulnerable to HepB infection due to uremia-related immune dysfunction, frequent interventions they exposed, and health-care personnel’s unsafe care. The vaccination against HepB confers the primary preventive measure. However, unresponsiveness to vaccination constitutes a major problem. Several factors can influence the immune response to vaccines but human genetic variations are thought to strongly militate the variability in vaccine responsiveness. We aimed to determine the association with specific HLA alleles and response to HepB vaccination in hemodialysis patients. Methods: The study included in-center hemodialysis patients. We retrospectively collected data regarding demographic, clinical, and laboratory features including anti-HBs antibody, antibody to hepatitis C (anti-HCV), anti-HIV, and specific HLA class I and II alleles (HLA-A, HLB, HLA-DR) from electronical medical record system. The frequencies of HLA class I and II antigens in nonresponders and responders were analyzed. Results: The most commonly observed HLA alleles in patients were DQA1*01 (%73.7), DQA1*05 (%57.9), DQB1*03 (%53.8), DQB1*05 (%38.5), and DRB1*11 (%37.3), respectively. The frequency of HLA-B40 allel was significantly higher in nonresponders (p=0.02, OR=6.25, 95% CI =1.33-29.3). HLA-DQA1*01 and HLA-DQB1*05 alleles were observed significantly more in responders (p=0.019, OR =6.9, 95% CI=1.40-33.91, and p=0.028, OR =10, 95% CI=1.12-88.91, respectively). Conclusion: This is the first study to our knowledge demonstrating the association between antibody response to HBsAg and HLA-B40, HLA-DQA1*01, and HLA-DQB1*05 alleles in Turkish hemodialysis patients.

References

World Health Organization. Global Hepatitis Report 2017. Geneva: World Health Organization, 2017. 83 p.

Sit D, Esen B, Atay AE, Kayabaşı H. Is hemodialysis a reason for unresponsiveness to hepatitis B vaccine? Hepatitis B virus and dialysis therapy. World J Hepatol. 2015;7(5):761-8.

Eleftheriadis T, Pissas G, Antoniadi G, Liakopoulos V, Stefanidis I. Factors affecting effectiveness of vaccination against hepatitis B virus in hemodialysis patients. World J Gastroenterol. 2014;20(34):12018-25.

Ozdemir FN, Micozkadioglu H, Arat Z, Turan M, Gulmus S, Haberal M. The importance of A3 allele in response to hepatitis B vaccine in end-stage renal disease patients. Transplant Proc. 2004;36(9):2615-7.

Jafarzadeh A, Bagheri-Jamebozorgi M, Nemati M, Golsaz-Shirazi F, Shokri F. Human Leukocyte Antigens Influence the Antibody Response to Hepatitis B Vaccine. Iran J Allergy Asthma Immunol. 2015;14(3):233-45.

Zeeshan M, Jabeen K, Ali AN, Ali AW, Farooqui SZ, Mehraj V, et al. Evaluation of immune response to Hepatitis B vaccine in health care workers at a tertiary care hospital in Pakistan: an observational prospective study. BMC Infect Dis. 2007;7:120.

Hagedorn HJ, Rettmann NA, Dieperink EW, Durfee J, Aqel B. Antibody response to hepatitis B vaccine in substance use disorder patients. Drug Alcohol Depend. 2010;107(1):39-43.

Prather AA, Hall M, Fury JM, Ross DC, Muldoon MF, Cohen S, et al. Sleep and antibody response to hepatitis B vaccination. Sleep. 2012;35(8):1063-9.

Zuckerman JN. Protective efficacy, immunotherapeutic potential, and safety of hepatitis B vaccines. J Med Virol. 2006;78(2):169-77.

Tonnis WF, Amorij JP, Vreeman MA, Frijlink HW, Kersten GF, Hinrichs WL. Improved storage stability and immunogenicity of hepatitis B vaccine after spray-freeze drying in presence of sugars. Eur J Pharm Sci. 2014;55:36-45.

Sangaré L, Manhart L, Zehrung D, Wang CC. Intradermal hepatitis B vaccination: a systematic review and meta-analysis. Vaccine. 2009;27(12):1777-86.

Fakharzadeh S, Kalanaky S, Hafizi M, Goya MM, Masoumi Z, Namaki S, et al. The new nano-complex, Hep-c, improves the immunogenicity of the hepatitis B vaccine. Vaccine. 2013;31(22):2591-7.

Amirzargar AA, Mohseni N, Shokrgozar MA, Arjang Z, Ahmadi N, Yousefi Behzadi M, et al. HLA-DRB1, DQA1 and DQB1 alleles and haplotypes frequencies in Iranian healthy adult responders and non-responders to recombinant hepatitis B vaccine. Iran J Immunol. 2008;5(2):92-9.

Velu V, Saravanan S, Nandakumar S, Shankar EM, Vengatesan A, Jadhav SS, et al. Relationship between T-lymphocyte cytokine levels and sero-response to hepatitis B vaccines. World J Gastroenterol. 2008;14(22):3534-40.

Posteraro B, Pastorino R, Di Giannantonio P, Ianuale C, Amore R, Ricciardi W, et al. The link between genetic variation and variability in vaccine responses: systematic review and meta-analyses. Vaccine. 2014;32(15):1661-9.

Girndt M, Sester M, Sester U, Kaul H, Köhler H. Defective expression of B7-2 (CD86) on monocytes of dialysis patients correlates to the uremia-associated immune defect. Kidney Int. 2001;59(4):1382-9.

Lin SY, Liu JH, Wang SM, Wang IK, Tsai CA, Liu YL, et al. Association of response to hepatitis B vaccination and survival in dialysis patients. BMC Nephrol. 2012;13:97.

Li ZK, Nie JJ, Li J, Zhuang H. The effect of HLA on immunological

response to hepatitis B vaccine in healthy people: a meta-analysis. Vaccine. 2013;31(40):4355-61.

Mert G, Sengul A, Gul HC, Karakas A, Eyigun CP. The role of human leukocyte antigen tissue groups in hepatitis B virus vaccination in Turkey. J Microbiol Immunol Infect. 2014;47(1):9-14.

Hatae K, Kimura A, Okubo R, Watanabe H, Erlich HA, Ueda K, et al. Genetic control of nonresponsiveness to hepatitis B virus vaccine by an extended HLA haplotype. Eur J Immunol. 1992;22(7):1899-905.

Langö-Warensjö A, Cardell K, Lindblom B. Haplotypes comprising subtypes of the DQBl*O6 allele direct the antibody response after immunisation with hepatitis B surface antigen. Tissue Antigens. 1998;52(4):374-80.

Pol S, Legendre C, Mattlinger B, Berthelot P, Kreis H. Genetic basis of nonresponse to hepatitis B vaccine in hemodialyzed patients. J Hepatol. 1990;11(3):385-7.

Schillie SF, Spradling PR, Murphy TV. The immune response of hepatitis B vaccine among persons with diabetes: a systematic review of the literature. Diabetes Care. 2012;35(12):2690-7.

Stachowski J, Kramer J, Füst G, Maciejewski J, Baldamus CA, Petrányi GG. Relationship between the reactivity to hepatitis B virus vaccination and the frequency of MHC class I, II and III alleles in haemodialysis patients. Scand J Immunol. 1995;42(1):60-5.

Lai MW, Hsu CW, Lin CL, Chien RN, Lin WR, Chang CS, et al. Multiple doses of hepatitis B recombinant vaccine for chronic hepatitis B patients with low surface antigen levels: a pilot study. Hepatol Int. 2018;12(5):456-64.

Tsouchnikas I, Dounousi E, Xanthopoulou K, Papakonstantinou S, Thomoglou V, Tsakiris D. Loss of hepatitis B immunity in hemodialysis patients acquired either naturally or after vaccination. Clin Nephrol. 2007;68(4): 228-34.

Stachowski J, Pollok M, Barth C, Maciejewski J, Baldamus CA. Non-responsiveness to hepatitis B vaccination in haemodialysis patients: association with impaired TCR/CD3 antigen receptor expression regulating co-stimulatory processes in antigen presentation and recognition. Nephrol Dial Transplant. 1994;9(2):144-52.

Grzegorzewska AE, Swiderska MK, Mostowska A, Warchoł W, Jagodziński PP. Antibodies to HBV surface antigen in relation to interferon-λ3 in hemodialysis patients. Vaccine. 2016;34(41):4866-74.

Published
2019-09-19
How to Cite
1.
Ersan G, Ersan S, Kılıcaslan Ayna T. The association between HLA-B40, HLA-DQA1*01 and HLA-DQB1*05 alleles and antibody response to hepatitis B vaccination in turkish hemodialysis patients. Rev Nefrol Dial Traspl. [Internet]. 2019Sep.19 [cited 2024Jul.27];39(3):167-74. Available from: http://revistarenal.org.ar/index.php/rndt/article/view/461
Section
Original Article