title: Serological response to one intradermal or intramuscular hepatitis B virus vaccine booster dose in human immunodeficiency virus-infected nonresponders to standard vaccination.
abstract: OBJECTIVE
  Hepatitis B virus (HBV) vaccination is recommended for all human immunodeficiency virus (HIV)-infected patients without HBV immunity. However, serological response to standard HBV vaccination is frequently suboptimal in this population and the appropriate strategy for revaccination of HIV-infected nonresponders remained controversial. We aimed to determine the serological response to one booster dose of HBV vaccine given by intradermal (ID) or intramuscular (IM) route in HIV-positive nonresponders to standard HBV vaccination.
  
  
  METHODS
  In this study, 42 HIV-infected nonresponders were enrolled. We randomized them to receive either 10 μg (0.5 mL) for ID (20 cases) or 20 μg (1 mL) for IM (22 cases) administration of HBV vaccine as a one booster dose. After 1 month, anti-HBs titer was checked in all cases. A protective antibody response (seroconversion) defined as an anti-HBs titer ≥10 IU/L.
  
  
  RESULTS
  Seroconversion was observed in 47.6% of subjects after 1 ID dose. A total of 30% showed antibody titers above 100 IU/L. Except one case, all responders had CD4(+) >200 cells/mm(3). Mean anti-HBs titer was 146.5 ± 246 IU/L. After the one IM booster dose, seroconversion was observed in 50% of cases. A total of 36.3% of subjects had anti-HBs ≥100 IU/L. All responders had CD4(+) >200 cells/mm(3), except one case. Mean anti-HBs titer was 416.4 ± 765.6 IU/L. Responders showed significantly higher CD4(+) cell counts, in comparison to nonresponders (P < 0.001).
  
  
  CONCLUSIONS
  One booster dose administered IM or ID to HIV-infected nonresponders resulted in similar rates of seroconversion, overall response rate 50%. However, higher anti-HBs titers observed more frequently in IM group.
authors.affiliation: Department of Clinical Research, Pasteur Institute of Iran, Tehran, Iran.
authors.forename: Amitis
authors.initials: A
authors.lastname: Ramezani
authors.affiliation: Department of Imam Reza hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Janbakhsh
authors.affiliation: Department of Valiasr Hospital, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Gol-Mohammadi
authors.affiliation: Department of Iranian Society for Support of Patients with Infectious Disease, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Banifazl
authors.affiliation: Department of Clinical Research, Pasteur Institute of Iran, Tehran, Iran.
authors.forename: Arezoo
authors.initials: A
authors.lastname: Aghakhani
authors.affiliation: Department of Clinical Research, Pasteur Institute of Iran, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Eslamifar
authors.affiliation: Department of Loghman Hospital, Shahid Behesti University of Medical Sciences, Tehran, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Pournasiri
authors.affiliation: Department of Imam Reza hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
authors.forename: Behzad
authors.initials: B
authors.lastname: Mahdavian
authors.affiliation: Department of Tuberculosis and Pediatric Infectious Research Center, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Ali-Asghar
authors.initials: AA
authors.lastname: Farazi
authors.affiliation: Department of Tuberculosis and Pediatric Infectious Research Center, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Masoomeh
authors.initials: M
authors.lastname: Sofian
keywords: Booster dose; hepatitis B virus vaccination; human immunodeficiency virus; intradermal; intramuscular; nonresponder