AEGiS-15IAC: Efficacy to hepatitis B vaccination and its relationship with T CD45RA+ (naïve) and CD45RO+ (memory) subsets in HIV-1-infected subjects.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Efficacy to hepatitis B vaccination and its relationship with T CD45RA+ (naïve) and CD45RO+ (memory) subsets in HIV-1-infected subjects.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. B10392)

Casseb J, Veiga AP, Duarte AJ
FMUSP, Sao Paulo, Brazil

BACKGROUND: After successful HAART, there are increased numbers of T CD4+ memory and naïve cells, and there is an improvement of antibody response to new antigens. We studied the efficacy of vaccination against HBV in HIV-1-infected subjects on HAART and analyzed the factors involved in the failure.

METHODS: 55 HIV-1-infected patients and 20 healthy controls who had received 3 doses (0, 30 and 180 days) of recombinant DNA hepatitis B vaccine. Anti-HBs titers were quantified by commercial ELISA, and HIV-1 plasma viral load (VL) was determined by NASBA. Initially, the HIV groups were analyzed by the non-parametric Mann-Whitney's test. Univariate analysis was done with the t-test, Fisher's and Kruskal-Wallis's test. Regression analysis was carried out with the Cox's regression test.

RESULTS: The overall HBV vaccine seroconversion rate was 59% (32/55) for HIV+ group, and all the 20 healthy controls responded to vaccination. Considering CD4 count at the time of immunization, we found rates of 25% (2/8) in the<200 CD4 group, 65% for 200-499 cells/mm³ (16/28), and 81% (14/19) for the group with >500 cells/mm³. 30 HIV-1+ were considered to be responders (anti-HBs>10 UI/L) and there were 17 non-responders (anti-HBs<10 UI/L). The median CD4+ count at the time of vaccination among responders was 452 cell/mm³, significantly higher than in non-responders (359 cells/mm³, 20%, p=.03). Memory T CD4+ cells were also significantly (p=.04) higher in responders (255 cells/mm³) than in non-responders (178 cells/mm³). Also, viral load at the time of immunization was significantly (p=.03) higher in non-responders (3.63 log10) than in responders (2.86 log10,). Seven HIV-1-infected patients experienced a significant viral load increase, transient in five cases.

CONCLUSIONS: We concluded that total T CD4 cell count, memory T CD4+ cells and lower plasma VL in HIV-1+ treated with HAART could be used to predict the response to HBV vaccination.

Keywords: AEGIS, HIV-1, Antigens, CD45, Viral Load, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Antigens, CD4, Vaccination, Acquired Immunodeficiency Syndrome, Hepatitis B Vaccines, HIV Seropositivity, Hepatitis B Antibodies, Humans, immunology

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B10392