title: Association of CMV, HBV, or HCV co-infection with vaccine response in adults with well-controlled HIV infection.
abstract: Even after CD4 count recovery on antiretroviral therapy, HIV infection is associated with decreased response to most vaccines compared to the general population. Chronic infections with viruses such as cytomegalovirus (CMV), hepatitis B virus (HBV), and hepatitis C virus (HCV), which are more prevalent in HIV-infected populations, have been linked to immune dysfunction and decreased vaccine response in the general population. However, whether co-infection with these other viruses contributes to the decreased vaccine response seen in adults with well-controlled HIV infection is unknown. We conducted a secondary analysis of data and serum from adults with well-controlled HIV infection from an inactivated polio vaccine trial (224 subjects) and a pneumococcal conjugate vaccine study (128 subjects). We evaluated the association of CMV, HBV, or HCV co-infection with post-vaccination antibody levels using both univariate and multivariate analyses, controlling for factors such as age, race, CD4 count, comorbidities, smoking status, and baseline antibody levels. Ninety-three percent, 7%, and 14% of subjects were co-infected with CMV, HBV, and HCV respectively. On both univariate and multivariate analysis, neither CMV nor HCV co-infection were significantly associated with post-vaccination antibody levels to either vaccine. HBV co-infection was significantly associated with post-vaccination antibody concentrations for pneumococcal serotype 7F on univariate analysis and 6A on multivariate analysis, but the association was with higher antibody concentrations. In conclusion, co-infection with CMV, HBV, or HCV does not appear to contribute to the decreased vaccine response seen in adults with well-controlled HIV infection.
authors.affiliation: a Department of Internal Medicine , Eastern Virginia Medical School , Norfolk , VA , USA.|b Department of Microbiology and Molecular Cell Biology , Eastern Virginia Medical School , Norfolk , VA , USA.
authors.forename: S B
authors.initials: SB
authors.lastname: Troy
authors.affiliation: a Department of Internal Medicine , Eastern Virginia Medical School , Norfolk , VA , USA.
authors.forename: A E B
authors.initials: AE
authors.lastname: Rossheim
authors.affiliation: a Department of Internal Medicine , Eastern Virginia Medical School , Norfolk , VA , USA.
authors.forename: J
authors.initials: J
authors.lastname: Siik
authors.affiliation: c Center for Health Analytics and Discovery, Eastern Virginia Medical School , Norfolk , VA , USA.
authors.forename: T D
authors.initials: TD
authors.lastname: Cunningham
authors.affiliation: b Department of Microbiology and Molecular Cell Biology , Eastern Virginia Medical School , Norfolk , VA , USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Kerry
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D060085:Coinfection / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000276:immunology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D006509:Hepatitis B / Q000150:complications* / Q000276:immunology; D006526:Hepatitis C / Q000150:complications* / Q000276:immunology; D006801:Humans; D000071497:Immunogenicity, Vaccine; D008297:Male; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000276:immunology*; D011055:Poliovirus Vaccine, Oral / Q000008:administration & dosage / Q000276:immunology*; D012367:RNA, Viral / Q000097:blood; D013296:Streptococcus pneumoniae / Q000276:immunology; D018074:Vaccines, Conjugate / Q000008:administration & dosage / Q000276:immunology; D055815:Young Adult
chemical_list: D022242:Pneumococcal Vaccines; D011055:Poliovirus Vaccine, Oral; D012367:RNA, Viral; D018074:Vaccines, Conjugate
keywords: CMV; HBV; HCV; HIV; vaccine response