Vaccination against hepatitis B with 4-double doses increases response rates and antibodies titers in HIV-infected adults
| Autor: | Denise Vigo Potsch, Elisangela Ferreira da Silva, S. Tuboi, R.M.M. Mendonça, Luiz Antonio Bastos Camacho, Cleber F. Ginuino, Juliana Custódio Miguel, Paulo Feijó Barroso, R.B. Moreira, Livia Melo Villar |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Hepatitis B vaccine Population Dose-Response Relationship Immunologic HIV Infections Antiretroviral Therapy Highly Active Humans Medicine Hepatitis B Vaccines Hepatitis B Antibodies education Immunization Schedule Vaccines Synthetic education.field_of_study General Veterinary General Immunology and Microbiology biology business.industry Vaccination Public Health Environmental and Occupational Health Antibody titer virus diseases Viral Load Hepatitis B medicine.disease CD4 Lymphocyte Count Titer Infectious Diseases Antibody Formation Immunology HIV-1 biology.protein Molecular Medicine Female Antibody business Viral load |
| Zdroj: | Vaccine. 30:5973-5977 |
| ISSN: | 0264-410X |
| DOI: | 10.1016/j.vaccine.2012.07.028 |
| Popis: | Background: Antibody responses to standard regimens of hepatitis B (HBV) vaccination are lower in HIVinfected subjects and the best hepatitis B vaccine schedule in this population is not known. Objective: To assess the immunogenicity and to evaluate predictors of serologic response of a modified regimen of a HBV recombinant vaccine in a cohort of HIV-infected subjects. Methods: HIV-infected subjects received 4 doses (40 g) of a recombinant HBV vaccine at 0, 1, 2 and 6 months. Demographic information as well as CD4 cell count and plasma viral load were assessed at baseline. Protective and strong responses were defined as an anti-HBs titer ≥10 mIU/mL and ≥100 mIU/mL, respectively and were evaluated one month after the third and the fourth doses. Results: 163 HIV-infected individuals were evaluated 67 (40%) were male and median age was 37 years. Median CD4 cell count was 385 cells/mm3 and 113 (70%) had undetectable HIV-1 viral load. Protective antibody response was observed in 83 and 91% and a strong antibody response was observed in 62 and 80% of the subjects after 3 and 4 doses, respectively. In a multivariate logistic model undetectable HIV-1 viral load and higher CD4 cell counts were independent predictors of a strong antibody response after 4 doses. Patients with undetectable HIV viral load were almost 3 times more likely to have anti-HBs titers above 100 mIU/mL than those with detectable viral load. Conclusions: A 4-double-dose regimen of a recombinant HBV vaccine increased response rates and determined higher antibody titers which may translate in prolonged protection agains HBV. Inclusion of a fourth dose of HBV vaccine for HIV-infected subjects should be considered in the public health setting. |
| Databáze: | OpenAIRE |
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