High rates of serological response to a modified hepatitis B vaccination schedule in HIV-infected adults subjects.
We evaluated a modified HBV regimen in a cohort of HIV-infected subjects in Rio de Janeiro, Brazil. HIV-infected subjects with no serologic evidences of previous hepatitis B infection were immunized with 4 doses (40 microg each) of recombinant hepatitis B vaccine given at 0, 1, 2 and 6 months. Blood samples were collected 1 month after the last dose and anti-HBs titers were measured. A protective antibody response was defined as an anti-HBs titer >or=10 mIU/mL. Forty-seven subjects (30 women, 17 men; mean age was 36 years, ranging from 21 to 58 years) were included in the final analysis. Median baseline CD4+ lymphocyte count was 402 cells/mm(3) and 33 subjects (70%) had an HIV viral load below 80 copies/mL. A protective antibody response was observed in 42 (89%) subjects. Thirty-seven (78%) and 28 (60%) patients developed anti-HBs titers higher than 100 mIU/mL and 1000 mIU/mL, respectively. 1 out of 5 non-responders (20%) had an HIV viral load below the detection limit, in contrast with 32 (76%) of those with an adequate serologic response (p=0.02). These findings suggest that 4-double dose alternative schedule may be considered to overcome the lower seroconversion rates observed with the standard regimens in HIV-infected subjects.
Potsch
D V
DV
Adult Vaccination Center, School of Medicine, Universidade Federal do Rio de Janeiro, Brazil. dfvp@hucff.ufrj.br
Oliveira
M L A
ML
Ginuíno
C
C
Miguel
J C
JC
Oliveira
S A N
SA
Silva
E F
EF
Moreira
R B
RB
Cruz
G V M
GV
Oliveira
A L V S M
AL
Camacho
L A B
LA
Barroso
P F
PF
D000328:Adult; D001938:Brazil; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000276:immunology*; D006509:Hepatitis B / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D006801:Humans; D007115:Immunization Schedule; D007117:Immunization, Secondary / Q000379:methods; D008297:Male; D008875:Middle Aged; D014611:Vaccination / Q000379:methods*; D019562:Viral Load; D055815:Young Adult
D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines