Nosocomial transmission of HBV infection is important issue in dialysis centers. Unfortunately this high risk group responds less than others to HBV vaccination and The highest risk among patients for acquiring HBV infection occurred in the centers that provided dialysis to HBsAg-positive patients but did not separate infected patients by room and machine hemodialysis units also appear to be important contributing factors to the spread of this virus. There are many protocols for increasing the efficacy of HBV vaccination in this group.
Article Effect of levamisole supplementation on hepatitis B virus va...
Another way to improve the immunological response of vaccines in ESRD patients is to use an adjuvant therapy to vaccination, in order to stimulate the immune system of these patients. Several compounds have been tested, thymopentin, levamisole, zinc, interleukin, interferon, erythropoietin, immunomodulator. Two of the most studied adjuvant drugs were GM-CSF and Levamisole. However, there is no clear validated recommandations on the use of these drugs in ESRD patients.
We find GMCSF 150 micrograms S/Calong with DOUBLE DOSE HepB vaccine to provide high anti HBS titers .This is especially useful in patients who have not been vaccinated in early stages of CKD but present with ESRD WITHOUT VACCINATION and would want protective titers quickly while starting Hemodialysis in them.
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