Immune Response to Hepatitis B Virus Vaccination Among HIV-1 Infected And Uninfected Adults in Kenya

• Published in: The Journal of infectious diseases 2013-02, Vol.207 (3), p.402-410
• Main Authors: Irungu, Elizabeth, Mugo, Nelly, Ngure, Kenneth, Njuguna, Robert, Celum, Connie, Farquhar, Carey, Dhanireddy, Shireesha, Baeten, Jared M.
• Format: Article
• Language: English
• Subjects: Adult; Antibodies; Biological and medical sciences; CD4 Lymphocyte Count; Coinfection; Dosage; Female; Fundamental and applied biological sciences. Psychology; Hepatitis B; Hepatitis B - complications; Hepatitis B - immunology; Hepatitis B - prevention & control; Hepatitis B Antibodies - blood; Hepatitis B Antibodies - immunology; Hepatitis B Vaccines - administration & dosage; Hepatitis B Vaccines - immunology; Hepatitis B virus; HIV 1; HIV Infections - complications; HIV Infections - immunology; HIV Infections - virology; HIV/AIDS; Human immunodeficiency virus 1; Humans; Immune response; Immunization, Secondary; Infections; Infectious diseases; Kenya; Major and Brief Reports; Male; Medical sciences; Microbiology; Miscellaneous; RNA; T lymphocytes; Vaccination; Viral Load; Virology
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jis695

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%.