Immune response to the hepatitis B vaccine among HIV-infected adults in Uganda

Seremba, Emmanuel; Ocama, Ponsiano; Ssekitoleko, Richard; Mayanja‐Kizza, Harriet; Adams, Scott V.; Orem, Jackson; Katabira, Elly; Reynolds, Steven J.; Nabatanzi, Rose; Casper, Corey; Phipps, Warren

doi:10.1016/j.vaccine.2021.01.043

Cited by 9 publications

(10 citation statements)

References 42 publications

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“…As in other studies, the baseline CD4 cell count following the second dose played a vital role in the HB vaccination response in our study [ 20 , 24 , 33 , 36 , 37 ]. Crucially, the GMT of participants with CD4 counts of 350 cells/mm 3 or lower was 49.5 IU/L, significantly lower than that in the other two groups.…”

Section: Discussionsupporting

confidence: 76%

“…A large randomized trial evaluating three-dose 20 μg and four-dose 40 μg HB vaccination schedules in adults with HIV reported seroconversion rates of 65% and 82%, respectively [ 20 ]. Prospective studies and randomized trials have reported similar response rates of 50–62% [ 21 , 22 ], while other studies have reported similar or better rates, ranging from 84.15% to 92% [ 13 , 23 , 24 ]. One study, a randomized trial conducted in China, reported no significant difference in the seroconversion rate between standard and high dosages (20 μg vs. 60 μg) of recombinant HB vaccines (84.15% (69/82) vs. 90.36% (75/83)) [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

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Associated Factors and Immune Response to the Hepatitis B Vaccine with a Standard Schedule: A Prospective Study of People with HIV in China

et al. 2023

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Hepatitis B (HB) vaccination is recommended for people with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). We aimed to assess the immune response to the HB vaccine and associated factors using the standard vaccination schedule among people with HIV (PWH) in China. A prospective study was carried out from 2016 to 2020 in Beijing, China. PWH were given three 20 μg doses of recombinant HB vaccine at 0, 1, and 6 months. Blood samples were taken within 4–6 weeks after each dose to evaluate the anti-HBs levels. A total of 312 participants completed vaccination and serologic testing. The seroconversion (anti-HBs ≥ 10 IU/L) rates following the first, second, and third doses of the vaccine were 35.6% (95% CI: 30.3–40.9%), 55.1% (95% CI: 49.6–60.7%), and 86.5% (95% CI: 82.8–90.3%), respectively, and the geometric means of the anti-HBs titers were 0.8 IU/L (95% CI: 0.5–1.6 IU/L), 15.7 IU/L (95% CI: 9.4–26.3 IU/L), and 241.0 IU/L (95% CI: 170.3–341.1 IU/L), respectively. In multivariate analysis, after three doses of vaccination, age, CD4 cell count, and HIV-RNA viral load were significantly associated with strong, moderate, and weak response, respectively. These findings confirm that these personal health conditions are related to the HB response. HB vaccination in PWH using the standard schedule was still highly effective in the context of early treatment initiation, especially among participants aged 30 years and younger.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Associated Factors and Immune Response to the Hepatitis B Vaccine with a Standard Schedule: A Prospective Study of People with HIV in China

et al. 2023

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“…Several studies have shown that PLWH have lower responses to some types of vaccine, including hepatitis A, hepatitis B, and in uenza vaccine. These responses are dependent on the level of CD4 cell count [22][23][24][25]. CD4 is pivotal in orchestrating both the humoral and cellular immune responses to vaccination and has an essential impact on antibody production [26].…”

Section: Discussionmentioning

confidence: 99%

Humoral Immune Response to Inactivated COVID-19 Vaccination at the 3rd Month among People Living with HIV

Zou

Ming³

et al. 2022

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Background: Research on the immune response to inactivated COVID-19 vaccination among people living with HIV (PLWH) is limited, especially among those with low CD4+ T lymphocyte (CD4 cell) count. This cross-sectional study aimed to assess the humoral immune response to inactivated COVID-19 vaccination among PLWH compared to HIV negative controls (HNC) and to determine the impact of CD4 cell count on vaccine response among PLWH.Methods: The neutralizing antibodies (nAbs) and the specific IgM and IgG-binding antibody responses to the inactivated COVID-19 vaccine at the third month after the second dose of inactivated COVID-19 vaccination were measured among 138 PLWH and 35 HNC. Multivariable logistic regression and multiple linear regression models were conducted to identify factors associated with the seroconversion rate of antibodies and the magnitude of anti-SARS-CoV-2 antibody titers, respectively.Results: At the end of the third month after two doses of vaccination, the seroconversion rates of IgG were comparable between PLWH (8.7%; 95%CI, 3.9-13.5%) and HNC (11.4%; 95%CI, 0.3-22.5%), respectively. The median titers and seroconversion rate of nAbs among PLWH were 0.57 (IQR: 0.30-1.11) log10 BAU/mL and 29.0% (95%CI: 21.3-36.8%), respectively, both lower than those in HNC (P＜0.05). After adjusting for age, sex, comorbidities, and CD4 cell count, the titers and seroconversion rate of nAbs were comparable between PLWH and HNC (P＞0.05). Multivariable regression analyses showed that CD4 cell count＜200 /μL was independently associated with lower titers and seroconversion rate of nAbs among PLWH (P＜0.05). A positive correlation was observed between the CD4 cell count and nAbs titers in PLWH (Spearman'sρ=0.25, P=0.034). Conclusion: Our study concluded that the immune response to inactivated COVID-19 vaccination among PLWH was independently associated with CD4 cell count, PLWH with lower CD4 cell count showed a weaker humoral immune response, especially those with CD4 cell count＜200 /μL. This finding suggests that expanding COVID-19 vaccination coverage among PLWH is impendency. In addition, aggressive ART should be carried out for PLWH, especially for those with low CD4 cell count, to improve the immune response to vaccines.

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“…This co-infection is especially high in sub-Saharan Africa (SSA) where an estimated 2.6 million PWH are infected with HBV (7). In Uganda, the national prevalence of HIV-HBV coinfection is at 3.9% (8) and 12 out of every 1,000 PWH acquire HBV annually (9). PWH who are infected with HBV are six times more likely to rapidly progress to chronic infection compared to people without HIV (6, [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…Despite this, hepatitis B vaccination of HIV-infected adults in Uganda is currently not a routine practice (9). Since routine hepatitis B vaccination among newborns was implemented in 2000 in SSA (2002 in Uganda), majority of Africans born before 2000 missed out on free vaccination as infants (17).…”

Section: Introductionmentioning

confidence: 99%

Hepatitis B vaccination status and associated factors among people living with HIV in Gulu, Uganda: A cross-sectional study

Nakabuye,

Segawa,

Ojiambo

et al. 2024

Preprint

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Introduction: Hepatitis B vaccination is highly recommended among people with HIV (PWH) because they have a poor prognosis when infected with Hepatitis B virus (HBV). Among PWH, HBV infection s are more likely to progress to chronic hepatitis and liver cirrhosis. It is therefore important that PWH are vaccinated against HBV. However, in Uganda, hepatitis B vaccination among PWH is not standard practice indicating that its uptake may be minimal. We aimed to determine the hepatitis B vaccination status among PWH and the associated factors. Methods A cross-sectional study was conducted among 385 PWH in Gulu Regional Referral Hospital, Uganda. Proportions of PWH that are fully vaccinated against hepatitis B were reported with their 95% confidence intervals (CI). A modified Poisson regression model was used to determine factors associated with hepatitis B vaccination, estimating their Prevalence ratios (PR) and 95% CI. Results The median age of the participants was 37 years, (interquartile range [IQR] 30-45years) and 30.9% (95% CI; 26.3–35.5) were fully vaccinated against HBV. Urban residence (adjusted PR [aPR] = 1.59, 95% CI = 1.17–2.17), family history of Hepatitis B infection (aPR = 1.66, 95% CI = 1.06–2.61), and knowledge about HBV (aPR = 1.41, 95% CI = 1.06–1.89) were associated with being fully vaccinated against hepatitis B. Conclusion We found low coverage of hepatitis B vaccination among PWH attending Gulu Regional Referral Hospital. Hepatitis B vaccination programs should target PWH living in rural areas, with no family history of hepatitis B to educate them about HBV vaccine to increase coverage.

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Immune response to the hepatitis B vaccine among HIV-infected adults in Uganda

Cited by 9 publications

References 42 publications

Associated Factors and Immune Response to the Hepatitis B Vaccine with a Standard Schedule: A Prospective Study of People with HIV in China

Associated Factors and Immune Response to the Hepatitis B Vaccine with a Standard Schedule: A Prospective Study of People with HIV in China

Humoral Immune Response to Inactivated COVID-19 Vaccination at the 3rd Month among People Living with HIV

Hepatitis B vaccination status and associated factors among people living with HIV in Gulu, Uganda: A cross-sectional study

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