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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Factors associated with the immune response to hepatitis A vaccination in HIV-infected patients in the era of highly active antiretroviral therapy
Vaccine, Volume 31, No. 36, Year 2013
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Description
Introduction: HIV seropositivity is considered a risk factor for complications in hepatitis A virus (HAV) infection. HAV vaccination schedules are widely implemented in HIV-infected patients, but the immune response remains impaired. Methods: We analysed the response to vaccination (antiHAV titres ≥20. IU/l) in 282 HIV-infected patients included in a standard (1440 Elisa Units (EU) at 0, 6 months) or rapidly accelerated schedule (720 EU at 0, 7, 21 days and 6 months) between 1997 and 2009. Factors associated with the response to vaccination were analysed using logistic regression. Results: The overall response rate was 73.4%. Male sex (OR: 0.16, 95% CI 0.05-0.51) and hepatitis C virus co-infection (OR: 0.30, 95% CI 0.14-0.74) were associated with a lower probability of response. Protective antibody response was associated with a higher CD4/CD8 ratio (OR: 3.69, 95% CI 1.3-10.5) and having received two doses of standard schedule (compared with patients receiving only one dose of the same schedule) (OR: 2.51, 95% CI 1.22-5.15). Three doses of the rapidly accelerated schedule were not more effective than a single dose of 1440 EU (OR: 1.32, 95% CI 0.48-3.63). Conclusion: The low responses observed in patients receiving a single dose suggest the need to emphasize adhesion to vaccination protocols to avoid failure. The CD4/CD8 ratio may be considered as an immune status marker which could help to better choose the moment of vaccination. Our findings underscore the importance of identifying strategies that optimize the timing and effectiveness of hepatitis A vaccination in HIV-infected patients and of the need for further studies on individual factors such as sex and hepatitis C co-infection that may affect the response to vaccination. Likewise, the sub-optimal effectiveness of three doses of 720 EU in the rapidly accelerated schedule, if confirmed in future studies, might lead to a revision of the current schedule recommended for HIV-infected travellers. © 2013 Elsevier Ltd.
Authors & Co-Authors
Mena, Guillermo
Spain, Barcelona
Hospital Clinic Barcelona
Spain, Barcelona
Instituto de Salud Global de Barcelona
García-Basteiro, Alberto L.
Spain, Barcelona
Hospital Clinic Barcelona
Spain, Barcelona
Instituto de Salud Global de Barcelona
Llupià, Anna
Spain, Barcelona
Hospital Clinic Barcelona
Spain, Barcelona
Instituto de Salud Global de Barcelona
Costa, Josep Javier
Spain, Barcelona
Hospital Clinic Barcelona
Gatell, José Mariá A.
Spain, Barcelona
Hospital Clinic Barcelona
Garcìa, Félipe
Spain, Barcelona
Hospital Clinic Barcelona
Bayas, José María
Spain, Barcelona
Hospital Clinic Barcelona
Spain, Barcelona
Instituto de Salud Global de Barcelona
Statistics
Citations: 26
Authors: 7
Affiliations: 2
Identifiers
Doi:
10.1016/j.vaccine.2013.06.012
ISSN:
18732518
Research Areas
Infectious Diseases
Participants Gender
Male