Hepatitis B vaccine responsiveness and clinical outcomes in HIV controllers.

<h4>Background</h4>Hepatitis B virus (HBV) vaccine responsiveness is associated with reduced risk of AIDS or death in HIV-infected individuals. Although HIV controllers (HIC) typically have favorable immunologic and clinical characteristics compared to non-controllers, vaccine responsive...

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Autores principales:	Jason F Okulicz, Octavio Mesner, Anuradha Ganesan, Thomas A O'Bryan, Robert G Deiss, Brian K Agan
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c35c02ca17ed45088f223583ce0b763d
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spelling	oai:doaj.org-article:c35c02ca17ed45088f223583ce0b763d2021-11-25T06:03:38ZHepatitis B vaccine responsiveness and clinical outcomes in HIV controllers.1932-620310.1371/journal.pone.0105591https://doaj.org/article/c35c02ca17ed45088f223583ce0b763d2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25144773/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Hepatitis B virus (HBV) vaccine responsiveness is associated with reduced risk of AIDS or death in HIV-infected individuals. Although HIV controllers (HIC) typically have favorable immunologic and clinical characteristics compared to non-controllers, vaccine responsiveness has not been studied.<h4>Methods and findings</h4>In the U.S. Military HIV Natural History Study, HBV vaccine response was defined as antibody to hepatitis B surface antigen (anti-HBs) ≥ 10 IU/L after last vaccination. For determination of vaccine responsiveness, HIC (n = 44) and treatment-naïve non-controllers (n = 476) were not on highly active antiretroviral therapy (HAART) when vaccinated while treated non-controllers (n = 284) received all HBV vaccine doses during viral load (VL)-suppressive HAART. Progression to AIDS or death was also compared for all HIC (n = 143) and non-controllers (n = 1566) with documented anti-HBs regardless of the timing of HBV vaccination. Positive vaccine responses were more common in HIC (65.9%) compared to HAART-naïve non-controllers (36.6%; P<0.001), but similar to non-controllers on HAART (59.9%; P = 0.549). Factors associated with vaccine response for HIC compared to HAART-naïve non-controllers include HIC status (OR 2.65, 95% CI 1.23-5.89; P = 0.014), CD4 count at last vaccination (OR 1.28, 1.15-1.45 for every 100 cells/uL; P<0.001), and number of vaccine doses administered (OR 0.56, 0.35-0.88; P = 0.011). When HIC were compared to non-controllers on HAART, only CD4 count at last vaccination was significant (OR 1.23, 1.1-1.38 for every 100 cells/uL; P<0.001). The rate of AIDS or death per 100 person/years for HIC compared to non-controllers was 0.14 (95% CI 0-0.76) versus 0.98 (95% CI 0.74-1.28) for vaccine responders and 0 (95% CI 0-2.22) versus 4.11 (95% CI 3.38-4.96) for non-responders, respectively.<h4>Conclusions</h4>HIC have improved HBV vaccine responsiveness compared to treatment-naïve non-controllers, but similar to those on VL-suppressive HAART. Progression to AIDS or death can be predicted by HBV vaccine responder status for non-controllers, however these events are rarely observed in HIC.Jason F OkuliczOctavio MesnerAnuradha GanesanThomas A O'BryanRobert G DeissBrian K AganPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 8, p e105591 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jason F Okulicz Octavio Mesner Anuradha Ganesan Thomas A O'Bryan Robert G Deiss Brian K Agan Hepatitis B vaccine responsiveness and clinical outcomes in HIV controllers.
description	<h4>Background</h4>Hepatitis B virus (HBV) vaccine responsiveness is associated with reduced risk of AIDS or death in HIV-infected individuals. Although HIV controllers (HIC) typically have favorable immunologic and clinical characteristics compared to non-controllers, vaccine responsiveness has not been studied.<h4>Methods and findings</h4>In the U.S. Military HIV Natural History Study, HBV vaccine response was defined as antibody to hepatitis B surface antigen (anti-HBs) ≥ 10 IU/L after last vaccination. For determination of vaccine responsiveness, HIC (n = 44) and treatment-naïve non-controllers (n = 476) were not on highly active antiretroviral therapy (HAART) when vaccinated while treated non-controllers (n = 284) received all HBV vaccine doses during viral load (VL)-suppressive HAART. Progression to AIDS or death was also compared for all HIC (n = 143) and non-controllers (n = 1566) with documented anti-HBs regardless of the timing of HBV vaccination. Positive vaccine responses were more common in HIC (65.9%) compared to HAART-naïve non-controllers (36.6%; P<0.001), but similar to non-controllers on HAART (59.9%; P = 0.549). Factors associated with vaccine response for HIC compared to HAART-naïve non-controllers include HIC status (OR 2.65, 95% CI 1.23-5.89; P = 0.014), CD4 count at last vaccination (OR 1.28, 1.15-1.45 for every 100 cells/uL; P<0.001), and number of vaccine doses administered (OR 0.56, 0.35-0.88; P = 0.011). When HIC were compared to non-controllers on HAART, only CD4 count at last vaccination was significant (OR 1.23, 1.1-1.38 for every 100 cells/uL; P<0.001). The rate of AIDS or death per 100 person/years for HIC compared to non-controllers was 0.14 (95% CI 0-0.76) versus 0.98 (95% CI 0.74-1.28) for vaccine responders and 0 (95% CI 0-2.22) versus 4.11 (95% CI 3.38-4.96) for non-responders, respectively.<h4>Conclusions</h4>HIC have improved HBV vaccine responsiveness compared to treatment-naïve non-controllers, but similar to those on VL-suppressive HAART. Progression to AIDS or death can be predicted by HBV vaccine responder status for non-controllers, however these events are rarely observed in HIC.
format	article
author	Jason F Okulicz Octavio Mesner Anuradha Ganesan Thomas A O'Bryan Robert G Deiss Brian K Agan
author_facet	Jason F Okulicz Octavio Mesner Anuradha Ganesan Thomas A O'Bryan Robert G Deiss Brian K Agan
author_sort	Jason F Okulicz
title	Hepatitis B vaccine responsiveness and clinical outcomes in HIV controllers.
title_short	Hepatitis B vaccine responsiveness and clinical outcomes in HIV controllers.
title_full	Hepatitis B vaccine responsiveness and clinical outcomes in HIV controllers.
title_fullStr	Hepatitis B vaccine responsiveness and clinical outcomes in HIV controllers.
title_full_unstemmed	Hepatitis B vaccine responsiveness and clinical outcomes in HIV controllers.
title_sort	hepatitis b vaccine responsiveness and clinical outcomes in hiv controllers.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/c35c02ca17ed45088f223583ce0b763d
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Hepatitis B vaccine responsiveness and clinical outcomes in HIV controllers.

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