Hepatitis B vaccination uptake and correlates of serologic response among HIV-infected and uninfected men who have sex with men (MSM) in Bangkok,Thailand |
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| Institution: | 1. Thailand Ministry of Public Health–U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand;2. Division of HIV/AIDS Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA;3. Thai Red Cross Society AIDS Research Center, Bangkok, Thailand;1. State Key Laboratory of Virology and College of Life Sciences, Wuhan University, Wuhan 430072, China;2. Clinical Research Center, Wuhan Children''s Hospital, Wuhan 430016, China;1. Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda;2. Global Health Institute, University of Antwerp, Belgium;3. Clinical Epidemiology Unit, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda;4. Department of Paediatrics, Gulu University School of Medicine, Gulu, Uganda;5. Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda;1. Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands;2. Department of Pediatric Immunology and Infectious Diseases, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands;3. Netherlands Reference Laboratory of Bacterial Meningitis, Academic Medical Center, Amsterdam, The Netherlands;1. Departments of Clinical Virology (RJT, GJF, ST, PA), Gastrointestinal Sciences (CEE, GC), Staff and Students Health Services (HK), Immunohematololgy and Transfusion Medicine (MPC), Christian Medical College Hospital, Vellore, Tamil Nadu, India |
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| Abstract: | BackgroundVaccination against hepatitis B virus (HBV) is recommended for all HBV-susceptible men who have sex with men (MSM). There is limited information on correlates of immunity to HBV vaccination in this group. We present serologic response rates to hepatitis B vaccine and identify factors associated with impaired response among HIV-uninfected and HIV-infected Thai MSM.MethodologyHBV-susceptible volunteers were offered hepatitis B vaccination at months zero, one, and six. We measured baseline (pre-vaccination) total serum IgG and IgG subclasses (all participants), baseline CD4 count, and plasma HIV-1 viral load (PVL) (HIV+ participants). HBV serologies were retested at 12 months. Serologic responses were compared between all groups in men receiving three vaccine doses.Results511/651 HIV-negative and 64/84 HIV-positive participants completed the three-dose series. Response rates in HIV-uninfected and -infected participants were 90.1% vs. 50.0% (p < 0.0001). Median pre-vaccination IgG was higher among non-responders than responders overall (1238.9.0 vs. 1057.0 mg/dL, p = 0.003) and among HIV-infected participants (1534.0 vs. 1244.5 mg/dL, p = 0.005), but not significantly among HIV-uninfected participants (1105.5 vs. 1054.3 mg/dL, p = 0.96). Pre-vaccination IgG1 and IgG3 levels were higher among HIV-positive than HIV-negative participants (median 866.0 vs. 520.3, and 105.8 vs. 83.1 mg/dL, respectively, p < 0.0001). Among HIV-infected participants, median CD4 count in non-responders was 378 cells/μL vs. 431 cells/μL in responders (p = 0.20). Median PVL in non-responders was 64,800 copies/mL vs. 15500 copies/mL in responders (p = 0.04). Participants with pre-vaccination plasma IgG >1550 mg/dL and PVL >10,000 copies/mL were almost always non-responsive (p < 0.01).ConclusionsHIV infection was associated with poor vaccine responses. High plasma viral load, elevated pre-vaccination total serum IgG and elevated pre-vaccination IgG1 are associated with poorer response to vaccination among HIV-infected MSM. In this group, the combination of high PVL and pre-vaccination total IgG is highly predictive of vaccine failure. |
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| Keywords: | HIV HBV Vaccination Serologic response IgG Plasma viral load |
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