Antibody to human immunodeficiency virus (HIV) and suboptimal response to hepatitis B vaccination.
OBJECTIVE
To analyze the relation between human immunodeficiency virus (HIV) infection and the antibody response to plasma-derived hepatitis B vaccine.


METHODS
Open-label longitudinal cohort study; blinded laboratory studies.


METHODS
University-affiliated municipal hospital.


METHODS
Homosexually active men with negative assays for hepatitis B surface antigen (HBsAg), hepatitis B core antigen, and antibody to HBsAg; recruited in a sexually transmitted disease clinic or referred from community practitioners.


METHODS
Immunization with 20 micrograms of plasma-derived hepatitis B virus vaccine intramuscularly, repeated after 1 and 6 months; standardized evaluation at entry and at 1, 2, 6, and 7 months.


RESULTS
Low antibody response or nonresponse to vaccination occurred in 7 of 16 HIV-seropositive patients, compared with 6 of 68 HIV-seronegative patients (P = 0.002). Median levels of antibody to HBsAg 7 months after the first vaccine dose were 205.3 sample ratio units for HIV-seronegative patients and 15.5 sample ratio units for HIV-seropositive patients. By multivariate analysis, vaccine response was associated with HIV antibody status and not with cytomegalovirus infection, lymphocyte subset results, or impaired cutaneous delayed hypersensitivity.


CONCLUSIONS
Infection with HIV is associated with suboptimal antibody response to plasma-derived hepatitis B virus vaccine. Determination of antibody levels after vaccination in HIV-seropositive patients may be warranted.
Collier
A C
AC
University of Washington, Seattle.
Corey
L
L
Murphy
V L
VL
Handsfield
H H
HH
D000328:Adult; D002452:Cell Count; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000276:immunology*; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000096:biosynthesis; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D017325:Hepatitis B Vaccines; D006716:Homosexuality; D006801:Humans; D008297:Male; D013601:T-Lymphocytes / Q000276:immunology; D014761:Viral Hepatitis Vaccines / Q000276:immunology*
D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D014761:Viral Hepatitis Vaccines