Antibody to Human Immunodeficiency Virus (HIV) and Suboptimal Response to Hepatitis B Vaccination

  1. Ann C. Collier, MD;
  2. Lawrence Corey, MD;
  3. Victory L. Murphy, CRN; and
  4. H. Hunter Handsfield, MD

    Abstract

    Study Objective: To analyze the relation between human immunodeficiency virus (HIV) infection and the antibody response to plasma-derived hepatitis B vaccine.

    Design: Open-label longitudinal cohort study; blinded laboratory studies.

    Setting: University-affiliated municipal hospital.

    Patients: Homosexually active men with negative assays for hepatitis B surface antigen (HBsAg), hepatitis B core antigen, and antibody to HBsAg; recruited in a sexually transmitted disease clinic or referred from community practitioners.

    Interventions: Immunization with 20 µg of plasma-derived hepatitis B virus vaccine intramuscularly, repeated after 1 and 6 months; standardized evaluation at entry and at 1, 2, 6, and 7 months.

    Measurements and Main Results: Low antibody response or nonresponse to vaccination occurred in 7 of 16 HIV-seropositive patients, compared with 6 of 68 HIV-seronegative patients (P = 0.002). Median levels of antibody to HBsAg 7 months after the first vaccine dose were 205.3 sample ratio units for HIV-seronegative patients and 15.5 sample ratio units for HIV-seropositive patients. By multivariate analysis, vaccine response was associated with HIV antibody status and not with cytomegalovirus infection, lymphocyte subset results, or impaired cutaneous delayed hypersensitivity.

    Conclusions: Infection with HIV is associated with suboptimal antibody response to plasma-derived hepatitis B virus vaccine. Determination of antibody levels after vaccination in HIV-seropositive patients may be warranted.

    Article and Author Information

    • From the University of Washington and Seattle-King County Department of Public Health, Seattle, Washington. For current author addresses, see end of text.

    • Grant support: Partial support by National Institutes of Health grants AI-12192, AI-07044, AI-07140, and AI-18649.

    • Requests for Reprints: Ann C. Collier, MD, Harborview Medical Center, 325 Ninth Avenue, ZA-00, Seattle, WA 98104.

    • Current Author Addresses: Dr. Collier: Department of Medicine, University of Washington School of Medicine, Seattle, WA 98014. Dr. Corey: Departments of Medicine and Laboratory Medicine, University of Washington School of Medicine, Seattle, WA 98104. Ms. Murphy: Seattle-King County Department of Public Health, Seattle, WA 98104.

      Dr. Handsfield: Department of Medicine, University of Washington School of Medicine; and Seattle-King County Department of Public Health, Seattle, WA 98104.

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    1. Ann Intern Med July 15, 1988 vol. 109 no. 2 101-105
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