Factors for predicting successful immune response to hepatitis B vaccination in HIV-1 infected patients.

This study aimed to determine the predicting factors for successful hepatitis B vaccination among HIV-1 infected patients. A prospective study was conducted among HIV-1 infected patients who had negative HBV serologies. Anti-HBs antibody was evaluated one month after completing a 3-injection course of hepatitis B vaccine. Patients who had an anti-HBs antibody level >10 mlU/ml were defined as responders. There were 65 patients with a mean age of 39+/-8.5 years, 68% were females. Fifty-seven (88%) patients had received antiretroviral therapy for a mean (SD) duration of 26.1 (22.3) months and 75% of these had an HIV-1 RNA count <50 copies/ml. The mean (SD) CD4 cell count and percentage at the time of vaccination were 345 (194) cells/mm3 and 16 (7) %, respectively. Thirty patients (46%) were responders. Compared to non-responders, responders had a higher mean CD4 cell count (p = 0.047) and a trend toward a younger age (p = 0.052). On multivariate analysis, younger age (p = 0.049) and higher CD4 cell count (p = 0.048) were predictors for successful response to hepatitis B vaccination. Determination of antibody levels after vaccination in HIV-infected patients is warranted.

Isolated antibody to hepatitis B core antigen in HIV-1 infected patients and a pilot study of vaccination to determine the anamnestic response.

BACKGROUND: Isolated antibody to hepatitis B core antigen (anti-HBc) is frequently found in HIV-infected patients. The present study aimed to determine the prevalence and risk factors of isolated anti-HBc and the anamnestic response to hepatitis B vaccination in this population. MATERIAL AND METHOD: HIV-infected patients who visited Ramathibodi Hospital in May 2006 were included to test hepatitis B serology. Subjects with isolated anti-HBc were given hepatitis B vaccine and tested for anti-HBs. RESULTS: Of 140 patients, 28 (20%) had isolated anti-HBc. From multivariate analysis, IVDU (OR 30.8, p < 0.001) and anti-HCV seropositive (OR 6.7, p = 0.002) were independent risk factors for isolated anti-HBc. Two from 28 (7%) patients who received vaccine had a response to vaccination. CONCLUSION: Prevalence of isolated anti-HBc among Thai HIV-infected patients was 20%. Risk factors of isolated anti-HBc were IVDU and anti-HCV seropositive. Anamnestic response to hepatitis B vaccination was low. Further study with strategies to improve the response of vaccination is needed.