title: Delayed-type hypersensitivity and hepatitis B vaccine responses, in vivo markers of cellular and humoral immune function, and the risk of AIDS or death.
abstract: BACKGROUND
  Delayed-type hypersensitivity (DTH) test responsiveness is associated with HIV disease progression; however it is unknown whether other immune markers, such as hepatitis B virus (HBV) vaccine seroresponse, also predict HIV outcomes.
  
  
  METHODS
  Eligible participants received HBV vaccine after HIV diagnosis, had non-anergic DTH testing at the time of last HBV vaccination, and available post-vaccine HBV antibody responses. The risk of progression to AIDS or death from the time of last HBV vaccination was evaluated.
  
  
  RESULTS
  Of 369 eligible participants with non-anergic DTH responses, 148 (40%) were HBV vaccine responders. In a multivariate model adjusted for age, CD4 count, viral load, and number of vaccinations, HBV vaccine non-responders had an increased risk of progression to AIDS or death (HR 1.81; 95% CI, 1.03-3.19).
  
  
  CONCLUSIONS
  HBV vaccine seroresponses were independent of DTH responses which suggest that non-response to HBV vaccine is not solely due to cell-mediated immune dysfunction in HIV-infected persons.
authors.affiliation: Department of Medicine, Division of Internal Medicine, San Antonio Military Medical Center, Fort Sam Houston, TX, United States.
authors.forename: Shane B
authors.initials: SB
authors.lastname: Patterson
authors.affiliation: Bellin Health, Green Bay, WI, United States.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Landrum
authors.affiliation: Infectious Disease Clinical Research Program, Uniformed Services University of Health Sciences, Bethesda, MD, United States; Infectious Disease Service, San Antonio Military Medical Center, Fort Sam Houston, TX, United States. Electronic address: jason.f.okulicz.mil@mail.mil.
authors.forename: Jason F
authors.initials: JF
authors.lastname: Okulicz
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology / Q000401:mortality; D000328:Adult; D000917:Antibody Formation; D017635:Clonal Anergy; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000276:immunology* / Q000401:mortality; D006510:Hepatitis B Antibodies / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000276:immunology*; D007111:Immunity, Cellular; D008297:Male; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012189:Retrospective Studies
chemical_list: D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines
keywords: AIDS; Anergy; Delayed-type hypersensitivity; HIV; Hepatitis B vaccine