Serological responses to revaccination against HBV HBV in HIV HIV ‐positive patients born in the era of nationwide neonatal HBV HBV vaccination

摘要

Abstract Background Serological responses to revaccination against hepatitis B virus ( HBV ) are unclear in HIV ‐positive adults who had undergone neonatal HBV vaccination and whose antibodies against HBV had waned in the era of combination antiretroviral therapy ( cART ). Methods Between 2000 and 2017, 666 HIV ‐positive men who have sex with men ( MSM ) who were born after 1986, when nationwide neonatal HBV vaccination programme was implemented in Taiwan, were included for analyses. A serological response was defined when a hepatitis B surface antibody (anti‐ HB s) titre ≥10? mIU / mL was measured 4‐24?weeks after the third dose of HBV vaccination. Results During the study period, 295 (48.7%) HIV ‐positive MSM (mean age, 23.2?years) who had lost HBV seroprotection were eligible for revaccination; 171 (58.0%) received at least 1 dose (20‐μg) of HBV vaccine and 116 (39.3%) completed the 3‐dose schedule. The serological response rate to 3 doses of HBV revaccination was 74.0% and the rate of high‐titre response (anti‐ HB s titre ≥100? mIU / mL ) was 46.0%. The CD 4 count before the first dose (per 50‐cell/μL increment, adjusted odds ratio, 1.14; 95% confidence interval, 1.01‐1.29) was positively associated with the serological response. The incident rate of HBV infection was 9.2 per 1000?person‐years of follow‐up among the patients who were non‐responders after revaccination. Conclusions Despite HBV vaccination in the neonatal period, the serological response rate to HBV revaccination in HIV ‐positive MSM was modest and could wane rapidly. Regular testing of anti‐ HB s should be integrated into the HIV care despite cART containing HBV ‐active agents.