title: Immune response to hepatitis B virus vaccination among HIV-1 infected and uninfected adults in Kenya.
abstract: BACKGROUND
  In studies from high-income countries, human immunodeficiency virus type 1 (HIV-1)-infected persons have diminished responses to hepatitis B virus (HBV) vaccination, compared with HIV-1-uninfected persons, but data from other settings are limited.
  
  
  METHODS
  We compared the immune response to HBV vaccination among HIV-1-infected and HIV-1-uninfected Kenyan adults and assessed the response of HIV-1-infected initial nonresponders to revaccination with a standard HBV vaccine series.
  
  
  RESULTS
  Of 603 participants, 310 (51.4%) were HIV-1-infected, for whom the median CD4(+) T-cell count was 557 cells/μL (interquartile range, 428-725 cells/μL); none were receiving antiretroviral therapy. Nonresponse to HBV vaccine was higher among HIV-1-infected participants, compared with HIV-1-uninfected participants (35.8% vs 14.3%; odds ratio, 3.33; P < .001). Of 102 HIV-1-infected initial nonresponders, 88 (86.3%) responded to revaccination, for an overall response, including to revaccination, of 94.9%. Among HIV-1-infected individuals, lower CD4(+) T-cell counts and male sex were independent predictors of nonresponse to initial vaccination, and lower body mass index, higher plasma HIV-1 RNA levels, and longer time to revaccination predicted nonresponse to revaccination.
  
  
  CONCLUSIONS
  Kenyan adults had similar HBV vaccination responses as persons from high-income countries. Timely revaccination of HIV-1-infected nonresponders increased response to the vaccine to 95%.
authors.affiliation: Department of Epidemiology, University of Washington, Seattle, WA 98104, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Irungu
authors.forename: Nelly
authors.initials: N
authors.lastname: Mugo
authors.forename: Kenneth
authors.initials: K
authors.lastname: Ngure
authors.forename: Robert
authors.initials: R
authors.lastname: Njuguna
authors.forename: Connie
authors.initials: C
authors.lastname: Celum
authors.forename: Carey
authors.initials: C
authors.lastname: Farquhar
authors.forename: Shireesha
authors.initials: S
authors.lastname: Dhanireddy
authors.forename: Jared M
authors.initials: JM
authors.lastname: Baeten
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D060085:Coinfection; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000276:immunology / Q000821:virology; D006509:Hepatitis B / Q000150:complications / Q000276:immunology* / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood / Q000276:immunology; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000276:immunology*; D006801:Humans; D007117:Immunization, Secondary; D007630:Kenya; D008297:Male; D014611:Vaccination; D019562:Viral Load
chemical_list: D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines