Reuters Health Information (2005-05-10): HIV-infected patients with isolated anti-HBc antigen may require HBV vaccine
HIV-infected patients with isolated anti-HBc antigen may require HBV vaccine
Last Updated: 2005-05-10 16:24:48 -0400 (Reuters Health)
NEW YORK (Reuters Health) - A substantial number of
HIV-infected individuals who test positive for isolated antibody to
hepatitis B core antigen (anti-HBc) do not have an anamnestic or rapid
response to hepatitis B vaccine, according to a new study.
"This suggests that some of these subjects have not been previously
exposed to hepatitis B virus, and that the positive test in these cases
is a false positive result," lead investigator Dr. Rajesh T. Gandhi
from Massachusetts General Hospital in Boston told Reuters Health.
"If confirmed in larger studies, this finding would suggest that
HIV-positive subjects who test positive for isolated anti-HBc should
receive hepatitis B vaccination," Dr. Gandhi said.
It is unclear, at present, whether HIV-infected patients who test
positive for anti-HBc should be vaccinated with hepatitis B vaccine,
Dr. Gandhi and colleagues note in the May 1st issue of The Journal of
They assessed the anamnestic response rate in 69 HIV-infected
subjects who tested negative for hepatitis B surface antigen (HBsAg)
and antibody to HBsAg (anti-HBs) and were immunized with hepatitis B
Twenty-nine subjects (42%) tested positive for anti-HBc and 40 (58%) tested negative for anti-HBc.
According to the team, the overall rate of anamnestic response to
hepatitis B vaccination was low (16%) and did not differ significantly
between subjects who tested positive for anti-HBc (24%) and those who
tested negative for anti-HBc (10%) before vaccination.
This suggests that testing for anti-HBc alone "may not be a reliable assessment of protection from HBV infection," they contend.
An "unexpected finding," according to the team, was that
HIV/HCV-coinfected subjects were less likely to develop high anti-HBs
titers after the third vaccination than were those injected with HIV
Further study of the response to hepatitis B vaccination in larger
groups of HIV/HCV-coinfected individuals is warranted, they conclude.
J Infect Dis 2005;191:1435-1441.