Randomized controlled trial of hepatitis B virus vaccine in HIV-1-infected patients comparing two different doses

被引：59

作者：

Cornejo-Juárez P. ^{[1
]}

Volkow-Fernández P. ^{[1
]}

Escobedo-López K. ^{[2
]}

Vilar-Compte D. ^{[1
]}

Ruiz-Palacios G. ^{[2
]}

Soto-Ramírez L.E. ^{[2
]}

机构：

[1] Department of Infectious Diseases, Instituto Nacional de Cancerología, Tlalpan 14000 México, D.F.

[2] Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y de la Nutrición, Salvador Zubirán, Mexico City

来源：

AIDS Research and Therapy | / 3卷 / 1期

关键词：

Human Immunodeficiency Virus; Human Immunodeficiency Virus Infection; Human Immunodeficiency Virus Patient; Vaccine Dose; Seroconversion Rate;

D O I：

10.1186/1742-6405-3-9

中图分类号：

学科分类号：

摘要：

Background: Co-infection with hepatitis B virus (HBV) and human immunodeficiency virus (HIV) is not infrequent as both share same route of exposure. The risk of developing chronic hepatitis B virus is 6%, in general population but can reach 10-20% in HBV/HIV co-infected patients. When compared to general population, the response rate to HBV vaccine in HIV-infected patients is diminished, so previous studies have tried to improve this response using variety of schedules, doses and co-administration of immunomodulators. The purpose of this study was to evaluate two doses of recombinant HBV vaccine (10 or 40 μg), IM at 0, 1 and 6 months. Vaccination response was measured 30-50 days after last dose; titers of >9.9 IU/L were considered positive. Results: Seventy-nine patients were included, 48 patients (60.7%) serconverted. Thirty-nine patients (49.3%) received 10 μg vaccine dose, 24 patients (61.5%) seroconverted. Forty patients (50.7%) received 40 μg vaccine dose, 24 (60%) seroconverted. There were no differences between two doses. A statistically significant higher seroconversion rate was found for patients with CD4 cell counts at vaccination ≥ 200 cel/mm3 (33 of 38 patients, 86.8%), compared with those with CD4 < 200 cel/mm3 (15 of 41, 36.6%), [OR 11.44, 95% IC 3.67-35.59, p = 0.003], there were no differences between two vaccine doses. Using the logistic regression model, CD4 count <200 cel/mm3 were significantly associated with non serologic response (p = 0.003). None other variables such as gender, age, risk exposure for HIV, viral load, type or duration of HAART or AIDS-defining illness, were asociated with seroconversion. Conclusion: In this study, an increase dose of HBV vaccine did not show to increase the rate of response in HIV infected subjects. The only significant findings associated to the response rate was that a CD4 count ≥ 200 cel/mm3, we suggest this threshold at which HIV patients should be vaccinated. © 2006 Cornejo-Juárez et al; licensee BioMed Central Ltd.

引用

共 22 条

[1]

Biggar R., Goedert J., Hoofnagle J., Accelerated loss of antibody to hepatitis B surface antigen among immunodeficient homosexual men infected with HIV, N Engl J Med, 316, pp. 630-631, (1987)

[2]

Hadler S.C., Judson F.N., O'Malley P.M., Altman N.L., Penley K., Buchbinder S., Schable C.A., Coleman P.J., Ostrow D.N., Francis D.P., Outcome of hepatitis B virus infection in homosexual men and its relation to prior human immunodeficiency virus infection, J Infect Dis, 163, pp. 454-459, (1991)

[3]

Bruguera M., Cremades M., Salinas R., Costa J., Grau M., Sans J., Impaired response to recombinant hepatitis B vaccine in HIV-infected persons, J Clin Gastroenterol, 14, pp. 27-30, (1992)

[4]

Lazizi Y., Grangeot-Keros L., Delfraissy J., Boue F., Dubreuil P., Badur S., Pillot J., Reappearance of hepatitis B virus in immune patients infected with the human immunodeficiency virus type 1, J Infect Dis, 158, pp. 666-667, (1988)

[5]

Hadler S., Hepatitis B prevention and human immunodeficiency virus (HIV) infection, Ann Intern Med, 109, pp. 92-94, (1988)

[6]

Poles M., Lew E., Dieterich D., Diagnosis and treatment of hepatic disease in patients with HIV, Gastroenteral Clin North Am, 26, pp. 291-321, (1997)

[7]

Pomerantz R., Friedman L., Hepatitis B and human immunodeficiency virus: Double trouble, Gastroenterology, 101, pp. 862-863, (1991)

[8]

Bodsworth N., Cooper D., Donovan B., The influence of human immunodeficiency virus type 1 infection on the development of the hepatitis B virus carrier state, J Infect Dis, 163, pp. 1138-1140, (1991)

[9]

Koblin B., Taylor P., Rubinstein P., Stevens C., Effect of duration of hepatitis B virus infection on the association between human immunodeficiency virus type-1 and hepatitis B viral replication, Hepatology, 15, pp. 590-592, (1992)

[10]

Eskild A., Magnus P., Petersen G., Sohlberg C., Jensen F., Kittelsen P., Skaug K., Hepatitis B antibodies in HIV-infected homosexual men are associated with more rapid progression to AIDS, AIDS, 6, pp. 571-574, (1992)

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