Kidney Week

Abstract: FR-PO776

HBV Vaccination Non-Responders with ESRD Demonstrate Available Cellular Memory Immunity Against Hepatitis B Vaccine

Session Information

• Dialysis: Inflammation and Infection
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Awad, Gounwa, University Hospital Marien Hospital Herne, Herne, Germany

Gounwa Awad,

• Nienen, Mikalai, University Hospital Marien Hospital Herne, Herne, Germany

Mikalai Nienen,

• Stervbo, Ulrik, University Hospital Marien Hospital Herne, Herne, Germany

Ulrik Stervbo,

• Bauer, Frederic, University Hospital Marien Hospital Herne, Herne, Germany

Frederic Bauer,

• Seibert, Felix S., University Hospital Marien Hospital Herne, Herne, Germany

Felix S. Seibert,

• Westhoff, Timm H., University Hospital Marien Hospital Herne, Herne, Germany

Timm H. Westhoff,

• Babel, Nina, University Hospital Marien Hospital Herne, Herne, Germany

Nina Babel,

Background

In the compromised immune system of patients with end-stage renal disease (ESRD) undergoing hemodialysis, the adequacy of host protection upon hepatitis B vaccination is crucial. Whereas seroconversion rates to hepatitis B (HBV) vaccine in this population is known to be lower than the general population, the cellular immune response to the vaccine in hemodialysis patients remain under study. Here, we functionally analyze and quantify HBV surface antigen (HBsAg)-specific T cells in patients with ESRD vaccinated against HBV with HBsAg vaccine. Cellular immunity against HBsAg and its correlation with humoral response were explored in 35 patients with ESRD undergoing hemodialysis and 13 healthy controls (HC).

Methods

Patients were divided according to their Hepatitis B vaccine titers into three groups: High responders (HR), Low-responders (LR), Non-responders (NR). Using multi-parameter flow cytometry HBsAg-specific T cells were quantified and functionally analyzed according to expression of activation markers CD40L and/or CD137 and cytokine release upon stimulation with HBsAg overlapping peptide pools. We also performed immunophenotyping of B cells, dendritic cells and regulatory T cells.

Results

HBsAg-specific CD4+T cells were detected not only in LR (88.8%) and HR (100%) but also in almost all NR; 78.6% of NR demonstrated HBsAg-specific memory T-cell response. Counts of HBsAg-specific CD4+CD40L+ T cells were significantly higher in HR compared to NR (p<0.001). No difference in cytokine release between the groups was. A correlation between vaccine-specific CD4+ T cell response and humoral response was identified (r=0.7537, p=0.0021). No significant difference was found in the number of myeloid and plasmacystoid dendritic cells between patients with ESRD of different titer groups. Interestingly, they were significantly higher in HR than in HC (p<0.05). A significantly larger Naïve B cell (IgD+CD27-) population was found in HR and HC compared to NR (p<0.05).

Conclusion

Our results show that HBV-specific memory T cells producing effector cytokines are detectable in humoral non-responders and might provide antiviral effects in case of HBV exposure in ESRD patients.

Funding

• Government Support - Non-U.S.