Yi-Chia Huang1, Szu-Min Hsieh1, Wang-Huei Sheng1,2, Yu-Shan Huang3, Kuan-Yin Lin4, Guan-Jhou Chen1, Shang-Ping Yang2, Wen-Chun Liu1, Yi-Ching Su1, Hsin-Yun Sun1, Chien-Ching Hung1,5,6,7, Shan-Chwen Chang1. 1. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. 2. Center of Infection Control, National Taiwan University Hospital, Taipei, Taiwan. 3. Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan. 4. Department of Medicine, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan. 5. Department of Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan. 6. Department of Medical Research, China Medical University Hospital, Taichung, Taiwan. 7. China Medical University, Taichung, Taiwan.
Abstract
BACKGROUND: Serological responses to revaccination against hepatitis B virus (HBV) are unclear in HIV-positive adults who had undergone neonatal HBV vaccination and whose antibodies against HBV had waned in the era of combination antiretroviral therapy (cART). METHODS: Between 2000 and 2017, 666 HIV-positive men who have sex with men (MSM) who were born after 1986, when nationwide neonatal HBV vaccination programme was implemented in Taiwan, were included for analyses. A serological response was defined when a hepatitis B surface antibody (anti-HBs) titre ≥10 mIU/mL was measured 4-24 weeks after the third dose of HBV vaccination. RESULTS: During the study period, 295 (48.7%) HIV-positive MSM (mean age, 23.2 years) who had lost HBV seroprotection were eligible for revaccination; 171 (58.0%) received at least 1 dose (20-μg) of HBV vaccine and 116 (39.3%) completed the 3-dose schedule. The serological response rate to 3 doses of HBV revaccination was 74.0% and the rate of high-titre response (anti-HBs titre ≥100 mIU/mL) was 46.0%. The CD4 count before the first dose (per 50-cell/μL increment, adjusted odds ratio, 1.14; 95% confidence interval, 1.01-1.29) was positively associated with the serological response. The incident rate of HBV infection was 9.2 per 1000 person-years of follow-up among the patients who were non-responders after revaccination. CONCLUSIONS: Despite HBV vaccination in the neonatal period, the serological response rate to HBV revaccination in HIV-positive MSM was modest and could wane rapidly. Regular testing of anti-HBs should be integrated into the HIV care despite cART containing HBV-active agents.
BACKGROUND: Serological responses to revaccination against hepatitis B virus (HBV) are unclear in HIV-positive adults who had undergone neonatal HBV vaccination and whose antibodies against HBV had waned in the era of combination antiretroviral therapy (cART). METHODS: Between 2000 and 2017, 666 HIV-positive men who have sex with men (MSM) who were born after 1986, when nationwide neonatal HBV vaccination programme was implemented in Taiwan, were included for analyses. A serological response was defined when a hepatitis B surface antibody (anti-HBs) titre ≥10 mIU/mL was measured 4-24 weeks after the third dose of HBV vaccination. RESULTS: During the study period, 295 (48.7%) HIV-positive MSM (mean age, 23.2 years) who had lost HBV seroprotection were eligible for revaccination; 171 (58.0%) received at least 1 dose (20-μg) of HBV vaccine and 116 (39.3%) completed the 3-dose schedule. The serological response rate to 3 doses of HBV revaccination was 74.0% and the rate of high-titre response (anti-HBs titre ≥100 mIU/mL) was 46.0%. The CD4 count before the first dose (per 50-cell/μL increment, adjusted odds ratio, 1.14; 95% confidence interval, 1.01-1.29) was positively associated with the serological response. The incident rate of HBV infection was 9.2 per 1000 person-years of follow-up among the patients who were non-responders after revaccination. CONCLUSIONS: Despite HBV vaccination in the neonatal period, the serological response rate to HBV revaccination in HIV-positive MSM was modest and could wane rapidly. Regular testing of anti-HBs should be integrated into the HIV care despite cART containing HBV-active agents.
Authors: Caroline Schmidbauer; David Chromy; Victor U Schmidbauer; Michael Schwarz; Mathias Jachs; David J M Bauer; Teresa Binter; Michael Apata; Dung T Nguyen; Mattias Mandorfer; Benedikt Simbrunner; Armin Rieger; Florian Mayer; Monika Breuer; Robert Strassl; Ralf Schmidt; Heidemarie Holzmann; Michael Trauner; Michael Gschwantler; Thomas Reiberger Journal: Liver Int Date: 2021-08-05 Impact factor: 8.754
Authors: Yoonjung Kim; Shin Woo Kim; Ki Tae Kwon; Hyun Ha Chang; Yoonhee Jun; Jang Wook Sohn; Dae Won Park; Joon Young Song; Jun Yong Choi; Hyo Youl Kim; June Myung Kim; Bo Youl Choi; Yunsu Choi; Mee Kyung Kee; Myeong Su Yoo; Jung Gyu Lee Journal: J Korean Med Sci Date: 2020-01-20 Impact factor: 2.153