ORIGINAL RESEARCH article
Front. Immunol.
Sec. Vaccines and Molecular Therapeutics
Evaluation of Anti-Tetanus IgG Antibody Levels and Influencing Factors in Patients Undergoing Hemodialysis
Provisionally accepted
Metin Özsoy1
Mehmet Emin Demir2*Hakkı Öztürk3Ayşegül Tuna4
Artuner Varlıbaş1
Salih Cesur1Altan Aksoy5
Aydın Çifci6- 1Clinic of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Turkey, Ankara, Türkiye
- 2Atılım University, Ankara, Türkiye
- 3Infectious Diseases Epidemiologist, Dialysis Physician, Private Ankara Dialysis Center, Ankara, Turkey, Ankara, Türkiye
- 4Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Kırıkkale University, Ankara, Türkiye
- 5Department of Medical Microbiology, Ankara Bilkent City Hospital, Ankara, Türkiye, Ankara, Türkiye
- 6Department of Internal Medicine, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey, Ankara, Türkiye
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Aim: This study aimed to assess anti-tetanus IgG antibody levels and identify determinants of inadequate tetanus immunity among maintenance hemodialysis (HD) patients. Methods: In this cross-sectional study, anti-tetanus IgG levels were measured by quantitative ELISA in 162 adult HD patients from two dialysis centers in Ankara, Turkey. Protective immunity was evaluated using both international (≥ 0.1 IU/mL) and robust (≥ 0.5 IU/mL) cut-offs. Demographic and clinical factors associated with immunity were analyzed by multivariate logistic regression. Results: Only 16.7 % of HD patients achieved robust protection (≥ 0.5 IU/mL), whereas 49.8 % had minimal protection (≥ 0.1 IU/mL). Protective immunity was independently associated with younger age (OR 1.07 per year; p = 0.004), shorter dialysis duration (OR 1.07; p = 0.030), male sex (female OR 2.92; p = 0.048), and recent booster vaccination within 10 years (OR 0.11; p < 0.001). Diabetes mellitus was not an independent factor. Conclusion: Most HD patients lacked durable tetanus immunity, particularly older females on long-term dialysis. The findings highlight the need for regular antibody monitoring, early revaccination, and structured booster programs to maintain adequate protection in this high-risk population.
Keywords: hemodialysis, Tetanus, vaccine immunity, Anti-tetanus IgG, Immunocompromised hosts
Received: 05 Aug 2025; Accepted: 18 Nov 2025.
Copyright: © 2025 Özsoy, Demir, Öztürk, Tuna, Varlıbaş, Cesur, Aksoy and Çifci. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mehmet Emin Demir, demirmehmetemin@hotmail.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.