{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T05:25:24Z","timestamp":1764739524805,"version":"3.46.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aimed to assess anti-tetanus IgG antibody levels and identify determinants of inadequate tetanus immunity among maintenance hemodialysis (HD) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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 (\u2265 0.1 IU\/mL) and robust (\u2265 0.5 IU\/mL) cut-offs. Demographic and clinical factors associated with immunity were analyzed by multivariate logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Only 16.7% of HD patients achieved robust protection (\u2265 0.5 IU\/mL), whereas 49.8% had minimal protection (\u2265 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 &amp;lt; 0.001). Diabetes mellitus was not an independent factor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2025.1678676","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T05:20:24Z","timestamp":1764739224000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of anti-tetanus IgG antibody levels and influencing factors in patients undergoing 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