期刊
INTERNATIONAL JOURNAL OF STD & AIDS
卷 19, 期 9, 页码 600-604出版社
SAGE PUBLICATIONS LTD
DOI: 10.1258/ijsa.2007.007197
关键词
HIV; hepatitis B vaccination; antibody response
资金
- NIAID NIH HHS [P30 AI027757, P30 AI027757-12, P30 AI027757-169007, P30 AI 27757] Funding Source: Medline
Protective response rates to hepatitis B (HB) vaccination have been reported as low as 18-62% in HIV-infected persons. The relative importance of various predictors for this poor response has not been fully characterized. In this retrospective cohort study, we examined the relationship between clinical characteristics and vaccine non-response (HB surface antibody 10 IU/L) among patients attending an urban HIV clinic. Among the 97 patients who met the inclusion criteria, 43 (44%) developed a protective antibody response. In multivariate analyses, age >40 years (odds ratio [OR] 3.03 [95% confidence interval [Cl], 1.14-8.06]; P = 0.026) and alcohol abuse (OR 4.92 [95% Cl, 1.72-20.89]; P = 0.007) were independent predictors of failure to develop vaccine response. In addition, CD4 nadir <200 (OR 7.24 [95% Cl, 1.91-27.41]; P = 0.004), rather than CD4 current to vaccination, remained a strong independent risk factor. Patients with HIV viral suppression on highly active antiretroviral therapy had a significantly lower rate of vaccine failure (OR 0.31 [95% Cl, 0.11-0.91]; P = 0.033), after adjusting for these other covariates. Our findings underscore the importance of confirming seroconversion after HB vaccination in HIV-infected patients and initiating vaccination early in the course of HIV infection.
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