Jung-Hwan Lee1, Seri Hong2, Jae Hyoung Im3, Jin-Soo Lee4, Ji Hyeon Baek5, Hea Yoon Kwon6. 1. Department of Internal Medicine, Inha University School of Medicine, Incheon, Republic of Korea. Electronic address: for_dream@nate.com. 2. National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea. Electronic address: srhong@ncc.re.kr. 3. Department of Internal Medicine, Inha University School of Medicine, Incheon, Republic of Korea. Electronic address: dylife83@naver.com. 4. Department of Internal Medicine, Inha University School of Medicine, Incheon, Republic of Korea. Electronic address: ljinsoo@inha.ac.kr. 5. Department of Internal Medicine, Inha University School of Medicine, Incheon, Republic of Korea. Electronic address: jhbaek@inha.ac.kr. 6. Department of Internal Medicine, Inha University School of Medicine, Incheon, Republic of Korea. Electronic address: xnanoomeex@gmail.com.
Abstract
INTRODUCTION: The prevalence of co-infection of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) is high and increases risk of hepatitis B chronicity and mortality. Despite guidelines for HIV-infected patients to be immunized against HBV, the immunogenicity of the HBV vaccination in HIV-infected patients is lower than that in the HIV-seronegative population. METHOD: In this study, we performed a systematic review of the literature and meta-analysis of randomized clinical trials to investigate the response rate to an increased dose of HBV vaccination in HIV-infected patients. A fixed-effects model, with heterogeneity and sensitivity analyses, was used. We identified nine studies involving 970 HIV-positive vaccine recipients. RESULTS: The study results were divided into two groups, depending on the time when antibody against hepatitis surface antigen was measured. Results showed a significant increase in response rates among patients who received a double dose of the vaccine versus the standard dose in both subgroups; the pooled odds ratio (OR) was 1.76 (95% confidence interval [CI]: 1.36-2.29) and 2.28 (95% CI: 1.73-3.01) for the rate that was measured 4-6 weeks and >12 months after completion of vaccination, respectively. The total OR was 1.99 (95% CI: 1.64-2.41). No heterogeneity was found. DISCUSSION: Our meta-analysis shows that a double dose of the HBV vaccine may significantly improve the immune response in HIV-infected patients. Higher immunogenicity was observed, when it was measured 4-6 weeks and >12 months after completion of the vaccination.
INTRODUCTION: The prevalence of co-infection of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) is high and increases risk of hepatitis B chronicity and mortality. Despite guidelines for HIV-infectedpatients to be immunized against HBV, the immunogenicity of the HBV vaccination in HIV-infectedpatients is lower than that in the HIV-seronegative population. METHOD: In this study, we performed a systematic review of the literature and meta-analysis of randomized clinical trials to investigate the response rate to an increased dose of HBV vaccination in HIV-infectedpatients. A fixed-effects model, with heterogeneity and sensitivity analyses, was used. We identified nine studies involving 970 HIV-positive vaccine recipients. RESULTS: The study results were divided into two groups, depending on the time when antibody against hepatitissurface antigen was measured. Results showed a significant increase in response rates among patients who received a double dose of the vaccine versus the standard dose in both subgroups; the pooled odds ratio (OR) was 1.76 (95% confidence interval [CI]: 1.36-2.29) and 2.28 (95% CI: 1.73-3.01) for the rate that was measured 4-6 weeks and >12 months after completion of vaccination, respectively. The total OR was 1.99 (95% CI: 1.64-2.41). No heterogeneity was found. DISCUSSION: Our meta-analysis shows that a double dose of the HBV vaccine may significantly improve the immune response in HIV-infectedpatients. Higher immunogenicity was observed, when it was measured 4-6 weeks and >12 months after completion of the vaccination.
Authors: Ainsley Ryan Yan Bin Lee; Shi Yin Wong; Louis Yi Ann Chai; Soo Chin Lee; Matilda Xinwei Lee; Mark Dhinesh Muthiah; Sen Hee Tay; Chong Boon Teo; Benjamin Kye Jyn Tan; Yiong Huak Chan; Raghav Sundar; Yu Yang Soon Journal: BMJ Date: 2022-03-02