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Elizabeth Irungu, Nelly Mugo, Kenneth Ngure, Robert Njuguna, Connie Celum, Carey Farquhar, Shireesha Dhanireddy, Jared M. Baeten, Immune Response to Hepatitis B Virus Vaccination Among HIV-1 Infected And Uninfected Adults in Kenya, The Journal of Infectious Diseases, Volume 207, Issue 3, 1 February 2013, Pages 402–410, https://doi.org/10.1093/infdis/jis695
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Abstract
Background. In studies from high-income countries, human immunodeficiency virus type 1 (HIV-1)–infected persons have diminished responses to hepatitis B virus (HBV) vaccination, compared with HIV-1–uninfected persons, but data from other settings are limited.
Methods. We compared the immune response to HBV vaccination among HIV-1–infected and HIV-1–uninfected Kenyan adults and assessed the response of HIV-1–infected initial nonresponders to revaccination with a standard HBV vaccine series.
Results. Of 603 participants, 310 (51.4%) were HIV-1–infected, for whom the median CD4+ T-cell count was 557 cells/μL (interquartile range, 428–725 cells/μL); none were receiving antiretroviral therapy. Nonresponse to HBV vaccine was higher among HIV-1–infected participants, compared with HIV-1–uninfected participants (35.8% vs 14.3%; odds ratio, 3.33; P < .001). Of 102 HIV-1–infected initial nonresponders, 88 (86.3%) responded to revaccination, for an overall response, including to revaccination, of 94.9%. Among HIV-1–infected individuals, lower CD4+ T-cell counts and male sex were independent predictors of nonresponse to initial vaccination, and lower body mass index, higher plasma HIV-1 RNA levels, and longer time to revaccination predicted nonresponse to revaccination.
Conclusions. Kenyan adults had similar HBV vaccination responses as persons from high-income countries. Timely revaccination of HIV-1–infected nonresponders increased response to the vaccine to 95%.
