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Serological response to hepatitis B virus vaccine in HIV-infected children in Tanzania

  1. F Pippi1,
  2. L Bracciale1,
  3. L Stolzuoli1,
  4. R Giaccherini1,
  5. E Montomoli2,
  6. C Gentile2,
  7. S Filetti3,
  8. A De Luca4,
  9. C Cellesi1

Article first published online: 28 JUN 2008

DOI: 10.1111/j.1468-1293.2008.00598.x

Issue

HIV Medicine

HIV Medicine

Volume 9, Issue 7, pages 519–525, August 2008

Additional Information

How to Cite

Pippi, F., Bracciale, L., Stolzuoli, L., Giaccherini, R., Montomoli, E., Gentile, C., Filetti, S., De Luca, A. and Cellesi, C. (2008), Serological response to hepatitis B virus vaccine in HIV-infected children in Tanzania. HIV Medicine, 9: 519–525. doi: 10.1111/j.1468-1293.2008.00598.x

Author Information

  1. 1

    Clinic of Infectious Diseases,

  2. 2

    Institute of Hygiene,

  3. 3

    Department of Internal Medicine, University of Siena, Siena, Italy

  4. 4

    Clinic of Infectious Disease, Catholic University of Sacred Heart, Rome, Italy

* Dr Francesco Pippi, Clinica di Malattie Infettive, Università di Siena, Policlinico le Scotte, viale Bracci 16, 53100 Siena, Italy. Tel: +39 (0) 577 586 533; fax: +39 (0) 577 233 462; e-mail: pippi.francesco@libero.it

Publication History

  1. Issue published online: 12 AUG 2008
  2. Article first published online: 28 JUN 2008
  3. Received: 19 November 2007, accepted 11 April 2008

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Keywords:

  • HBV immunization;
  • paediatric HIV;
  • Tanzania

Background

HIV-infected children have a lower seroconversion rate to hepatitis B virus (HBV) immunization than healthy children. Previous studies have produced conflicting results on CD4 cell counts as predictors of vaccine response. No study has evaluated the response rate to HBV vaccination in HIV-infected children receiving highly active antiretroviral therapy (HAART). Our aim was to vaccinate HIV-infected children living in a close community and to investigate the anamnestic response rate after vaccination with its predictors.

Methods

Eighty-four HIV-positive children aged 1–10 years who were negative for antibodies to the HBV core antigen (anti-HBc) completed immunization with three doses of 5 μg HBVAXPRO (Aventis, Milan, Italy). Quantitative testing for antibodies to the HBV surface antigen (anti-HBs) was performed: a seroprotective titre was defined as anti-HBs>10 mUI/mL.

Results

After the vaccination, the anti-HBs seroconversion rate was 59.5%. It was higher in individuals in Centers for Disease Control and Prevention (CDC) immune category 1 than in those in CDC categories 2 and 3. Seroconversion was found in 70.8% of HAART-treated and 44.4% of treatment-naïve children. In multivariable models, HAART use and absolute CD4 cell counts were independently associated with probability of seroconversion and with higher anti-HBs titres.

Conclusions

We found a higher seroconversion rate compared with previous studies in HIV-infected children. In children who are candidates to receive antiretroviral therapy, it may be advisable to defer HBV vaccination until after treatment initiation.

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