BACKGROUND: Patients with HIV-infection often respond poorly to vaccination. We sought to determine rates of seroconversion among HIV-infected patients receiving the hepatitis B vaccine and for non-responders who received high-dose revaccination. METHODS: A single-center retrospective chart review was performed. Patients received either a series of Engerix-B (20 mcg) or Twinrix (standard dose vaccine [SDV]). A subset of non-responders received a higher 40 mcg dose series of Engerix-B (high-dose revaccination [HDR]). RESULTS: 215 patients received SDV with an overall response rate of 46.5%. Among the 115 non-responders, 30 received HDR with an overall response rate of 66.7%. Factors associated with response to SDV included younger age (odds ratio [OR]/1 year=0.97, P=.03), higher CD4 at first dose (OR/100 CD4=1.13, P=.02), and receipt of Twinrix versus Engerix-B (OR=2.3, P=.003). Higher CD4 at first dose was also associated with response to HDR (OR/100 CD4=2.0, P=.02). All factors remained independently associated with response to SDV and HDR on multivariable analysis. CONCLUSIONS: HDR appears to be a viable strategy to achieve seroconversion among HIV-infected patients who fail to respond to SDV. Higher CD4 at vaccination, younger age, and receipt of Twinrix were independently associated with SDV seroconversion.
BACKGROUND:Patients with HIV-infection often respond poorly to vaccination. We sought to determine rates of seroconversion among HIV-infectedpatients receiving the hepatitis B vaccine and for non-responders who received high-dose revaccination. METHODS: A single-center retrospective chart review was performed. Patients received either a series of Engerix-B (20 mcg) or Twinrix (standard dose vaccine [SDV]). A subset of non-responders received a higher 40 mcg dose series of Engerix-B (high-dose revaccination [HDR]). RESULTS: 215 patients received SDV with an overall response rate of 46.5%. Among the 115 non-responders, 30 received HDR with an overall response rate of 66.7%. Factors associated with response to SDV included younger age (odds ratio [OR]/1 year=0.97, P=.03), higher CD4 at first dose (OR/100 CD4=1.13, P=.02), and receipt of Twinrix versus Engerix-B (OR=2.3, P=.003). Higher CD4 at first dose was also associated with response to HDR (OR/100 CD4=2.0, P=.02). All factors remained independently associated with response to SDV and HDR on multivariable analysis. CONCLUSIONS: HDR appears to be a viable strategy to achieve seroconversion among HIV-infectedpatients who fail to respond to SDV. Higher CD4 at vaccination, younger age, and receipt of Twinrix were independently associated with SDV seroconversion.
Authors: George K Siberry; Mark J Abzug; Sharon Nachman; Michael T Brady; Kenneth L Dominguez; Edward Handelsman; Lynne M Mofenson; Steve Nesheim Journal: Pediatr Infect Dis J Date: 2013-11 Impact factor: 2.129
Authors: Inés Herrero-Fernández; Yolanda M Pacheco; Ezequiel Ruiz-Mateos; Manuel Leal; Miguel Genebat; María Del Mar Rodriguez-Méndez; María Del Carmen Lozano; María José Polaino; Isaac Rosado-Sánchez; Laura Tarancón-Diez; María Ángeles Muñoz-Fernández Journal: Antimicrob Agents Chemother Date: 2017-12-21 Impact factor: 5.191
Authors: E Seremba; P Ocama; R Ssekitoleko; H Mayanja-Kizza; S V Adams; J Orem; E Katabira; S J Reynolds; R Nabatanzi; C Casper; W Phipps Journal: Vaccine Date: 2021-01-28 Impact factor: 3.641