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HBV revaccination recommended for HIV-infected teens.


CONSIDER REVACCINATING all perinatally HIV-infected adolescents who did not initiate highly active antiretroviral therapy (HAART) at the time of initial infant hepatitis B virus (HBV) vaccination, with a three-dose HBV schedule, recommended researchers at Mahidol University, Bangkok, in a recent study.

In a prospective study from March 2012 to March 2014 ultimately involving 162 perinatally HIV-infected adolescents with immune reconstitution, only 3.6% were receiving HAART at the time of initial infant HBV vaccination and 96.3% had undetectable antihepatitis B surface antibodies (anti-HBs) at baseline. Adolescents with breakthrough HBV infection had been excluded from the cohort.

After the first dose of HBV revaccination, 58% of the adolescents developed anti-HBs greater than or equal to 10 mIU/mL; 27.8% had anti-HBs greater than or equal to 100 mIU / mL and thus didn't receive the third revaccination. Of the 117 who received the third dose, 97% developed anti-HBs greater than or equal to 10 mIU/mL. There were four nonresponders after the three doses who were given an additional three doses; they then had anti-HBs greater than or equal to 100 mIU/mL.

In a multivariate analysis, there was no independent factor that was associated with the presence of immune memory defined as anti-HBs greater than or equal to 100 mIU/mL, wrote lead researcher Keswadee Lapphra, MD, and her associates (Ped Inf Dis J. 2017. doi: 10.1097/ inf.0000000000001613).

In a previous study, 71% of three-dose revaccinated persons retained protective antibodies against HBV at 3-year follow-up; this was a similar rate to that reported in healthy HIV-infected children after their infant primary HBV series (Vaccine. 2011 May 23;29[23]:3977-81), they said.

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Title Annotation:ASTHMA
Author:Nellist, Catherine Cooper
Publication:Pediatric News
Article Type:Clinical report
Date:May 1, 2017
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