title: Prevalence of protective level of hepatitis B antibody 3 years after revaccination in HIV-infected children on antiretroviral therapy.
abstract: After responding to highly active antiretroviral therapy (HAART), HIV-infected children had a good response to hepatitis B immunization. However, there are limited data on the durability of antibody to hepatitis B surface antigen (anti-HBs) in these children. The primary objective of this study is to determine the prevalence of protective anti-HBs level 3 years after a 3-dose HBV revaccination among HIV-infected children with immune recovery (CD4 cell ≥ 15%) while on HAART. The secondary objective is to assess immunologic memory among children who had waning of anti-HBs. An anti-HBs level of ≥ 10 mIU/mL was defined as a protective antibody level. Sixty-nine HIV-infected children who had history of a 3-dose HBV revaccination while receiving HAART were enrolled. The mean (SD) of CD4 cell and duration of HAART at time of revaccination was 27.2% (6.7) and 5.9 years (0.4), respectively. The proportion of children with protective anti-HBs level 3 years after the revaccination was 71.0% [95% CI, 58.8-81.3]. The geometric mean titer was 114(SD 5)IU/mL. By multivariate logistic analysis, the predictors for protective anti-HBs level 3 years after revaccination were CD4 cell count ≥ 500 cells/mm³ at the time of vaccination (p = 0.04) and anti-HBs level ≥ 100 IU/mL at 1 month after completion of the 3-dose vaccination (p < 0.001). Anamnestic response after one booster dose was demonstrated among 14 of 17 children who had waning protective anti-HBs level (82.4% [95% CI, 62.2-102.6]). Our findings support the recommendation of giving a 3-dose HBV vaccination to HIV-infected children with immune recovery while receiving HAART.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Mongkol
authors.initials: M
authors.lastname: Lao-Araya
authors.forename: Thanyawee
authors.initials: T
authors.lastname: Puthanakit
authors.forename: Linda
authors.initials: L
authors.lastname: Aurpibul
authors.forename: Sineenart
authors.initials: S
authors.lastname: Taecharoenkul
authors.forename: Thira
authors.initials: T
authors.lastname: Sirisanthana
authors.forename: Virat
authors.initials: V
authors.lastname: Sirisanthana
mesh_terms: D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D018791:CD4 Lymphocyte Count; D002648:Child; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000276:immunology* / Q000821:virology; D015497:HIV-1; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D006510:Hepatitis B Antibodies / Q000097:blood* / Q000276:immunology; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000276:immunology* / Q000627:therapeutic use; D006801:Humans; D007117:Immunization, Secondary / Q000379:methods*; D007156:Immunologic Memory; D008297:Male; D015995:Prevalence; D013997:Time Factors
chemical_list: D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines