CPG 7909 Adjuvant Improves Hepatitis B Virus Vaccine Protection
in HIV Positive Adults on HAART
Individuals
with HIV often have an incomplete response to HBV
vaccination due to immunological
impairment. In the present study, researchers
evaluated CPG 7909, a synthetic oligodeoxynucleotide containing
immunostimulatory CpG motifs, as an adjuvant to the Energix-B
vaccine.
This randomized, double-blind controlled trial was conducted
to determine safety and hepatitis B virus (HBV) immunogenicity
in adult HIV subjects on effective antiretroviral therapy.
HBV-susceptible subjects, half of whom had failed previous
vaccination, were vaccinated at 0, 1 and 2 months with a
double dose of Energix-B with/without (+/-) 1 mg CPG 7909.
HBV immune subjects (anti-HBsAg titres >= 10 mIU/l)
received either CPG 7909 alone or saline. Safety, anti-HBs
titres and lymphocyte proliferation response (LPR) to HBsAg were assessed
over 12 months.
Results:
·
Vaccinations
with Energix-B +/- CPG 7909 were well tolerated locally
and systemically.
·
HIV
suppression and CD4
cell counts were maintained.
·
Anti-HBs titers
were significantly higher in vaccinees receiving CPG 7909,
for all time points after the second dose.
·
Seroprotective
titres (>= 10 mIU/ml) by 6 and 8 weeks, and 12 months
were found in 89, 89, and 100% of subjects receiving CPG
7909 compared to 53, 42, and 63% of controls respectively
(P = 0.029, 0.005, and 0.008).
·
HBsAg LPR
was increased at all time-points up to 12 months after vaccination
with addition of CPG 7909 (P < 0.05).
The authors conclude, “Addition of CPG 7909 achieves
rapid, higher, and sustained HBV seroprotection and increases
HBV-specific T helper cell response to HBV vaccine in HIV subjects.
These results confirm a potential adjuvant role for CPG
7909 in vaccine hyporesponsive populations including those
living with HIV.”
09/19/05
Reference
C L Cooper and others. CPG 7909 adjuvant improves hepatitis
B virus vaccine seroprotection in antiretroviral-treated
HIV-infected adults. AIDS 19(14): 1473-1479, September
23, 2005.
