Reuters Health Information (2005-10-04): Low HIV load tied to hepatitis B vaccination success
Low HIV load tied to hepatitis B vaccination success
Last Updated: 2005-10-04 15:05:31 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Successful hepatitis B
vaccination in HIV-infected patients appears to be dependent on a low
plasma HIV RNA level, researchers report in the October 1st issue of
Clinical Infectious Diseases.
"Our data reinforce that HIV-infected adults respond poorly to
hepatitis B vaccination and that responses are improved with controlled
viremia," lead investigator Dr. Edgar Turner Overton told Reuters
Health. "With the current strategies of waiting to initiate
antiretroviral therapy...we are left with a question of when to
vaccinate against hepatitis B, at the point of entry to care with
ongoing viremia or several years later when viremia is controlled."
Dr. Overton of Washington University School of Medicine, St. Louis,
and colleagues retrospectively reviewed the records of 194 HIV-infected
patients who underwent hepatitis B vaccination.
Only 34 (17.5%) developed a protective antibody response. The sole
factor associated with a successful response was a plasma HIV RNA level
lower than 400 copies per mL at the time of vaccination (p = 0.003).
The researchers note that the responders were protected against
hepatitis B and none subsequently developed the infection. However, 10%
of nonresponders became infected.
Current vaccine strategies are not ideal, continued Dr. Overton.
"Fortunately, several new hepatitis B vaccines are being evaluated for
high risk persons with decreased response rates. We can hope that these
novel approaches will yield better rates of protection."
Clin Infect Dis 2005;41:1045-1048.