Repeat, Double-dose Hepatitis B Vaccination Provides Protection for People with HIV

The hepatitis B vaccine is universally recommended for people with HIV, but individuals with advanced immune suppression may not mount enough of an antibody response to an initial vaccination to provide protection against HBV infection. Thus, investigators have explored strategies such as higher vaccine doses or repeated inoculations.

As reported in the January 15, 2008 Journal of Infectious Diseases, Dutch researchers administered double-dose hepatitis B revaccination to 144 HIV positive individuals who did not respond adequately to an earlier vaccination attempt using a standard dose.

The authors found that the double-dose revaccination was effective in 50.7% of patients who had previously failed to respond to the usual doses. In a multivariate analysis, women had a significantly better response than men.

Interestingly, the effect of age on response depended on HIV viral load at the time of revaccination. For patients with detectable HIV RNA, the effect of age was stronger than for individuals with undetectable viral load (odds ratio 0.34 vs 0.74 per additional 10 years).

1/18/08

Reference
TE De Vries-Sluijs, BE Hansen, GJ van Doornum, and others. A Prospective Open Study of the Efficacy of High-Dose Recombinant Hepatitis B Rechallenge Vaccination in HIV-Infected Patients. Journal of Infectious Diseases 197(2): 292-294. January 15, 2008.