[ response to Hepatitis B virus vaccine in HIV-infected patients [HIV/AIDS counseling and care center in Kermanshah]]

Background and Objective: HBV infection is preventable by effective vaccination in general population, but response to vaccine among HIV infected people seems to be low

Methods: In this prospective study, 48 HIV position patients with anti HBs-Ab and HBs Ag had hepatitis B vaccination [0, 1, 6 months]. Anti-HBs levels were measured two months after the last dose by ELISA method. Cellular immunity was evaluated by flowcytometry

Findings: Only 14 [29.1%] of vaccinated HIV-infected patients had positive anti-HBs titers [11 males, 3 females]. Among them, 4 [28.6%] were over 40 years and from 34 HIV positive patients who did not respond to hepatitis B vaccine, 10 [29.4%] were over 40 years old. The mean number of CD4+ T lymphocytes was 352.5 in responders and 283.9 in non-responders. 2 [17.6%] of 17 HIV positive patients with CD4+ T <200 AND 6 [31.5%] of 19 HIV positive patients with 200500 responded to hepatitis B vaccine

Conclusion: Hepatitis B vaccination is better to be administered at the early stage of HIV infection. Conventional dose HIV vaccine is not enough for immunity. Therefore, it is recommended two-fold dose and repeated conventional dose or increasing interval administration of hepatitis B vaccine

Reduction of clinical tuberculosis in HIV-infected males with isoniazid prophylaxis

Isoniazid [INH] chemoprophylaxis has a positive impact on the development of clinical tuberculosis. Due to the increased prevalence of tuberculosis among HIV-infected individuals, we evaluated the effect of INH on the prevention of clinical tuberculosis in HIV-infected patients. We administered 300 mg of INH daily to 246 HIV-infected, tuberculin skin test-positive patients for 12 months. During 3 years of follow-up, 41 participants died and 94 were lost to follow up. Of the 111 patients followed for the 3 years, 12 developed tuberculosis which is lower than might be expected in an untreated group. INH prophylaxis appears to be an effective method to prevent clinical tuberculosis among HIV-infected, tuberculin skin test-positive patients

Thrombocytopenia in HIV-infected patients, Islamic Republic of Iran

Thrombocytopenia is a blood dyscrasia common in AIDS patients that may result from increased viral load and diminished CD4 T lymphocytes. We evaluated the rate of thrombocytopenia [platelet count < 100 000/microL] in 170 HIV-infected patients [161 males and 9 females] from May 2000-April 2001 in Kermanshah, Islamic Republic of Iran. All except 7 females were injecting drug users. While 34 patients had thrombocytopenia, 3 had severe thrombocytopenia [platelet count < 20 000/microL]. Although prevalence was similar in various stages of HIV infection [18.5%-22.5%], severe thrombocytopenia was in patients with CD4 T cell count < 200 cells/microL. There were no other associated conditions. Mild thrombocytopenia is common in HIV-infected patients in our region