Hepatitis B vaccination in infants of mothers infected with human immunodeficiency virus

Arrazola, M.P.; Juanes, J.R. de; Aragón, Andrés; Codes, A. García de; Ramos, José Tomás

doi:10.1002/jmv.1890450318

Cited by 30 publications

(9 citation statements)

References 7 publications

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“…In children with perinatally acquired infection, response rates range from 20 – 78% 1–6. Correlation of response with CD4+ T-cell (CD4) counts or percentages, HIV-related symptoms, and younger age are reported but with inconsistent findings.…”

Section: Introductionmentioning

confidence: 99%

Hepatitis B Vaccination in HIV-Infected Youth: A Randomized Trial of Three Regimens

Flynn¹,

Cunningham²,

Rudy³

et al. 2011

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background HIV-infected youth are at risk of hepatitis B (HBV) infection and should be vaccinated. Previous reports suggest reduced response to standard HBV vaccine regimens. Methods HIV-infected youth, age 12 to <25 years, were randomly assigned to one of three treatment arms: Arm 1: Engerix B®, 20 mcg HBsAg; Arm 2: Engerix B®, 40 mcg; and Arm 3: Twinrix®, 20mcg HBsAg combined with 720 ELU hepatitis A antigen. Vaccines were administered at weeks 0, 4 and 24. Results Characteristics of evaluable patients (n=336) at entry were similar in the study arms. At enrollment, median CD4+ T-cell count was 460 cells/mm3 (IQR: 305 to 668); 13% were < 200 cells/mm3. Among Engerix B®, 20 mcg recipients, 60.4% responded to vaccine (HBsAb ≥ 10 IU/mL at week 28). Improved vaccine response was seen in recipients of Engerix B®, 40 mcg, (73.2%, vs. Arm 1, p=0.04) and Twinrix® (75.4%, vs. Arm 1, p=0.02). In multivariate analysis, only baseline CD4+ T-cell count and study arm were independent predictors of vaccine response. Conclusions In HIV-infected youth, a three dose vaccination regimen with Engerix B®, 40 mcg, or Twinrix® and higher baseline CD4+ T-cell counts were independently associated with improved vaccine response.

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Section: Introductionmentioning

confidence: 99%

Hepatitis B Vaccination in HIV-Infected Youth: A Randomized Trial of Three Regimens

Flynn¹,

Cunningham²,

Rudy³

et al. 2011

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…[11–16] Risk factors for lack of a vaccine response include higher HIV RNA at the time of vaccination,[17, 18] anti-hepatitis C virus (HCV) positivity,[19, 20] and lower nadir CD4 cell count prior to vaccination,[21, 22] while CD4 cell count at the time of vaccination has not been consistently predictive. [11, 13, 15–18, 20, 23, 24] Several studies have also documented reduced durability of serologic responses to HBV vaccine in those infected with HIV compared to HIV-negative individuals[12, 23, 25, 26] leading some to recommend booster doses for HIV-infected patients when antibody to HBV surface antigen (HBsAb) levels fall below 10 IU/L,[2] although data supporting this practice are very limited.…”

Section: Introductionmentioning

confidence: 99%

Hepatitis B vaccination and risk of hepatitis B infection in HIV-infected individuals

Landrum

Hullsiek

Ganesan

et al. 2010

Aids

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Objective To assess the association of HBV vaccination with risk of HBV infection among HIV-infected patients and HBV infection risk factors among vaccinees. Design Observational cohort study Methods Participants enrolled from 1986 through 2004, unvaccinated and serologically negative for HBV infection at the time of HIV diagnosis, were followed longitudinally through 2007 for the occurrence of HBV infection. Risk factors for HBV infection were evaluated using time to event methods, including Kaplan-Meier survival curves and Cox proportional hazards models. Results During 11,632 person-years of follow-up, the rate of HBV infection was 2.01 (95% CI 1.75–2.27) /100 person-years. Receipt of at least one dose of vaccine was not associated with reduced risk of HBV (unadjusted HR 0.86, 95% CI 0.7–1.1; adjusted HR 1.08, 95% CI 0.8–1.4). Receipt of three or more doses of vaccine was also not associated with reduced risk (HR 0.96; 95% CI 0.56–1.64). Among 409 vaccinees with HBsAb <10 IU/L, 46 (11.2%) developed HBV infection compared to 11 of 217 (5.1%) vaccinees with HBsAb ≥10 IU/L (HR 0.51; 95% CI 0.3–1.0). In participants with initial HBsAb <10 IU/L, 16/46 (35%) infections were chronic, compared to 0/11 in those with initial HBsAb ≥10 IU/L (p=0.02). Conclusion Overall, HBV vaccination was not associated with reduced risk of HBV infection in our cohort of HIV-infected individuals. However, the small subset of vaccinees with a positive vaccine response may have had reduced HBV infection risk, including chronic disease. Improvements in vaccine delivery and immunogenicity are needed to increase HBV vaccine effectiveness in HIV-infected patients.

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“…Standard immunization schedules with a three‐dose regimen confer protection [antibodies to HBsAg (anti‐HBs) ≥10 mUI/mL] in >95% of immunocompetent children [8] but in HIV‐1‐infected patients the same regimen has been associated with lower seroconversion rates (25–41% in children) [9,10]. Some investigators have suggested that an increase in the dose or the frequency may improve the response in immunodeficient children [7].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies also produced conflicting results on the role of CD4 cell counts as predictors of HBV vaccine response in HIV‐infected adults [13] and children [9,10,14,15]. No study has to our knowledge evaluated the response rate to HBV vaccination in HIV‐infected children receiving highly active antiretroviral therapy (HAART).…”

Section: Introductionmentioning

confidence: 99%

Serological response to hepatitis B virus vaccine in HIV‐infected children in Tanzania

Pippi¹,

Bracciale²,

Stolzuoli³

et al. 2008

HIV Medicine

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BackgroundHIV-infected children have a lower seroconversion rate to hepatitis B virus (HBV) immunization than healthy children. Previous studies have produced conflicting results on CD4 cell counts as predictors of vaccine response. No study has evaluated the response rate to HBV vaccination in HIV-infected children receiving highly active antiretroviral therapy (HAART). Our aim was to vaccinate HIV-infected children living in a close community and to investigate the anamnestic response rate after vaccination with its predictors. MethodsEighty-four HIV-positive children aged 1-10 years who were negative for antibodies to the HBV core antigen (anti-HBc) completed immunization with three doses of 5 mg HBVAXPRO (Aventis, Milan, Italy). Quantitative testing for antibodies to the HBV surface antigen (anti-HBs) was performed: a seroprotective titre was defined as anti-HBs410 mUI/mL. ResultsAfter the vaccination, the anti-HBs seroconversion rate was 59.5%. It was higher in individuals in Centers for Disease Control and Prevention (CDC) immune category 1 than in those in CDC categories 2 and 3. Seroconversion was found in 70.8% of HAART-treated and 44.4% of treatmentnaïve children. In multivariable models, HAART use and absolute CD4 cell counts were independently associated with probability of seroconversion and with higher anti-HBs titres. ConclusionsWe found a higher seroconversion rate compared with previous studies in HIV-infected children. In children who are candidates to receive antiretroviral therapy, it may be advisable to defer HBV vaccination until after treatment initiation.

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Hepatitis B vaccination in infants of mothers infected with human immunodeficiency virus

Cited by 30 publications

References 7 publications

Hepatitis B Vaccination in HIV-Infected Youth: A Randomized Trial of Three Regimens

Hepatitis B Vaccination in HIV-Infected Youth: A Randomized Trial of Three Regimens

Hepatitis B vaccination and risk of hepatitis B infection in HIV-infected individuals

Serological response to hepatitis B virus vaccine in HIV‐infected children in Tanzania

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