الفهرس 
AcknowledgmentOnly 14 pages are availabe for public view
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Abstract
Hepatitis B infection is a global occurrence of major concern. Morbidity rtality from HBV infection are due to both early disease (acute hepatitis) te disease (chronic hepatitis, cirrhosis, and primary hepatocellular iilla). It is the cause of up to 80 of hepatocellular carcinoma. ~ccording to the World Health Organization, 2 billion persons worldwide een infected by the HBV, of whom more than 350 millions are chronic s. In addition, more than 250,000 persons die worldwide each year of :is B-associated acute and chronic liver disease. HBV is currently classified within the family Hepadnaviridae, the name cl from its hepatotropism and DNA genome. Electron microscopy of I ~y purified HBV from human serum reveals three types of particles: The :infectious virion, the spherical particles, and the filamentous particles. re small spherical and filamentous particles are surface coat protein and esent in excess over the intact infectious virion. ransmission of HBV infection occurs by percutaneous and permucosal lure, perinatal exposure, and sexual exposure. Percutaneous and ICQsal exposure entails blood to blood through interrupted skin or mucous mne as occurs in direct transfusion of blood and blood products and punctures. r Frequent exposure to blood is common among patients of HD units who rethus at highest risk of infection. It was found that HBV is the microbe that is lost efficiently transmitted in the dialysis setting. Immunization with hepatitis B vaccine is the most effective mean of leventing HEV infection and its consequences. It has been recommended for oili HD patients and staff members since it became available in 1982. The Ilcdne in use is the recombinant vaccine containing 10-40 j.lg of HBs Ag rotein Iml. . In 1998, the Ministry of Health (MOH) in Egypt had started a program of tratitis B vaccination for all HD patients. It has been agreed that anti-HBs Ive! of lOmIu/ml or more is regarded as seroprotective. Primary vaccination ~prises three intramuscular doses of vaccine, with the 2nd and 3 rd doses given Illd 6 months respectively after the 1 st. However, hepatitis B vaccine which shows efficient seroconverSlOn long normal adults, often gives poorer responses among HD patients. The !I tune response to hepatitis B vaccine is determined by various immunization host factors. Immunization factors include the dose of vaccine administered, vaccine schedule, the site and route of immunization. Host-related factors lude age, gender, obesity, smoking, and disease state. In Dialysis patients, an acquired defect in cellular immune response has !nadvocated by various authors. There is agreement about the main defect of eH immune response in uremia and recent interest about the role of monocyte ceil activation, sensitivity and interleukin production. The aim of the present study was to discuss some of the factors affecting immune response to hepatitis B vaccine and to determine the relation Itween IL-2 and the responsiveness to hepatitis B vaccine in HD patients and staff members. One hundred and seventy four persons vaccinated against HBV including D HO patients and 34 staff members from different hospitals in Alexandria re included in the study. All relevant information was collected from the dy population including personal data (e.g. name, age, sex, occupation, etc...) well as vaccine data (e.g. date of hepatitis B vaccination, compliance to :cine schedule, etc.. .). A blood sample was collected from each person and serum samples were led using ELISA technique for the presence of anti-HBc to exclude naturally uired HBV infection.