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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Hepatitis B virus prevalence and vaccine response in HIV-infected children and adolescents on combination antiretroviral therapy in Kigali, Rwanda
Pediatric Infectious Disease Journal, Volume 32, No. 3, Year 2013
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Description
Objective: The aim of this study was to determine the prevalence of hepatitis B virus (HBV) infection in a cohort of HIV-infected Rwandan children and adolescents on combination antiretroviral therapy (cART), and the success rate of HBV vaccination in those children found to be HBV negative. Methods: HIV-infected children and adolescents (age 8-17 years) receiving cART with CD4 T-cells count ≥200 cells/mm3 and/or ≥15% and without prior HBV vaccination (by history, vaccination cards and clinic records) underwent serologic testing for past (negative HBV surface antigen [HBsAg] with positive antibody to HBV core antigen [cAb] and to HBsAg [anti-HBs]) or active HBV infection (positive HBsAg). Children with any positive HBV serologic tests were excluded from further vaccination; all others completed 3 HBV immunizations with 10 μg of ENGERIX-B. Anti-HBs titer was measured 4-6 weeks after the last immunization. Results: Of 88 children, 6 (7%) children had active HBV infection and 8 (9%) had past HBV infection. The median (interquartile range) age, CD4 T-cell count and cART duration were 12.3 (10.1-13.9) years, 626 (503 to 942) cells/mm3 and 1.9 (1.5-2.7) years, respectively. Seventeen children had detectable plasma HIV-1 RNA. Seventy-3 children completed 3 immunizations with median (interquartile range) postimmunization anti-HBs concentration of 151 mlU/mL (1.03-650). Overall, 52 children (71%, 95% confidence interval: 61-82) developed a protective anti-HBs response. HIV-1 RNA and CD4 T-cell count were independent predictors of a protective anti-HBs response. Protective anti-HBs response was achieved in 82% of children with undetectable HIV-1 RNA and 77% with CD4 T cells >350/mm3. Conclusions: The substantial HBV prevalence in this cohort suggests that HIV-infected Rwandan children should be screened for HBV before cART initiation. HIV viral suppression and CD4 T cells ≥350/mm3 favored the likelihood of a protective response after HBV vaccination. Copyright © 2013 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Mutwa, Philippe Rutwaza
Rwanda, Kigali
Centre Hospitalier Universitaire de Kigali
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Boer, Kimberly Rachel
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Netherlands, Amsterdam
Royal Tropical Institute - Kit
Rusine, John B.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Rwanda, Kigali
National Reference Laboratory
Muganga, Narcisse
Rwanda, Kigali
Centre Hospitalier Universitaire de Kigali
Tuyishimire, Diane
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Rwanda, Kigali
Trac Plus - Center for Treatment and Research on Aids
Reiss, Peter
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Lange, Joep M.A.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Geelen, Sibyl P.M.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Netherlands, Utrecht
Wilhelmina Kinderziekenhuis
Statistics
Citations: 28
Authors: 8
Affiliations: 6
Identifiers
Doi:
10.1097/INF.0b013e318271b93d
ISSN:
08913668
e-ISSN:
15320987
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Rwanda