High rates of serological response to a modified hepatitis B vaccination schedule in HIV-infected adults subjects
Potsch, D.V.; Oliveira, M.L.A.; Ginuíno, C.; Miguel, J.C.; Oliveira, S.A.N.; Silva, E.F.; Moreira, R.B.; Cruz, G.V.M.; Oliveira, A.L.V.S.M.; Camacho, L.A.B.; Barroso, P.F.
Vaccine 28(6): 1447-1450
2010
ISSN/ISBN: 1873-2518 PMID: 19995540 DOI: 10.1016/j.vaccine.2009.11.066Document Number: 208420
We evaluated a modified HBV regimen in a cohort of HIV-infected subjects in Rio de Janeiro, Brazil. HIV-infected subjects with no serologic evidences of previous hepatitis B infection were immunized with 4 doses (40 microg each) of recombinant hepatitis B vaccine given at 0, 1, 2 and 6 months. Blood samples were collected 1 month after the last dose and anti-HBs titers were measured. A protective antibody response was defined as an anti-HBs titer >or=10 mIU/mL. Forty-seven subjects (30 women, 17 men; mean age was 36 years, ranging from 21 to 58 years) were included in the final analysis. Median baseline CD4+ lymphocyte count was 402 cells/mm(3) and 33 subjects (70%) had an HIV viral load below 80 copies/mL. A protective antibody response was observed in 42 (89%) subjects. Thirty-seven (78%) and 28 (60%) patients developed anti-HBs titers higher than 100 mIU/mL and 1000 mIU/mL, respectively. 1 out of 5 non-responders (20%) had an HIV viral load below the detection limit, in contrast with 32 (76%) of those with an adequate serologic response (p=0.02). These findings suggest that 4-double dose alternative schedule may be considered to overcome the lower seroconversion rates observed with the standard regimens in HIV-infected subjects.
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