title: Hepatitis B revaccination in HIV-infected vaccine non-responders: is double dosing always necessary?
abstract: Limited data exist on hepatitis B revaccination strategies for HIV-infected individuals who do not develop immunity after the first vaccination series. A retrospective cohort study was conducted to assess the immunogenicity of the second series of hepatitis B vaccine given in standard dosing (SD) and double dosing (DD) strategies among Thai HIV-infected adults during the period from January 2006 to December 2014. Of the 120 eligible patients, 68 (57%) were men, median age was 38 years old, 87 (73%) received SD and 33 (27%) received DD revaccination. The demographic and clinical characteristics of SD and DD groups were comparable. The overall vaccine response rate was significantly higher in DD group than SD group (97% vs. 70%; p = 0.001). Independent factors associated with no response to hepatitis B revaccination were receipt of SD vaccine (adjusted odds ratio [aOR] 16.04; p = 0.009), age ≥ 40 years (aOR 3.66; p = 0.009) and CD4 cell count at the time of revaccination less than 450 cells/µL (aOR 2.96; p = 0.04). These findings suggest that DD hepatitis B revaccination series should be given in HIV-infected patients who were at least 40 years old or had CD4 counts less than 450 cells/µL after no response to the first vaccination series.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.
authors.forename: Garnpawee
authors.initials: G
authors.lastname: Chatkittikunwong
authors.affiliation: Division of Infectious Diseases, Faculty of Medicine, Thammasat University, Pathumthani, Thailand thanak30@yahoo.com.
authors.forename: Thana
authors.initials: T
authors.lastname: Khawcharoenporn
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005602:France; D015658:HIV Infections / Q000276:immunology*; D006509:Hepatitis B / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology*; D006801:Humans; D007117:Immunization, Secondary / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013785:Thailand; D016896:Treatment Outcome; D014614:Vaccines, Synthetic / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology; D055815:Young Adult
chemical_list: D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines; D014614:Vaccines, Synthetic
keywords: AIDS; HIV; Hepatitis B; double dosing; human immunodeficiency virus; revaccination; vaccine non-responders