Hepatitis B virus (HBV) vaccine response is good in individuals with HIV and therefore should be given to aid in prevention of HBV, to reduce costs of treatment, and to help prevent HBV/HIV coinfection, according to a retrospective, descriptive study published in the Annals of Hepatology.1

HBV and HIV share the same route of transmission, mainly sexual and parenteral, which assists in the occurrence of HBV/HIV coinfection.2 Coinfection accelerates the course of liver disease,3,4 and the risk for progression to AIDS or death is almost double for those with HBV/HIV coinfection compared with individuals only infected with HIV.2,5-7 Ideally, persons infected with HIV without evidence of HBV immunity should be vaccinated against HBV soon after HIV diagnosis.8-11-12 However, the efficacy of vaccines against HBV decreases gradually after 40 years of age and with other factors such as obesity, stress, smoking, and alcohol abuse may also lower its efficacy. HBV vaccines are also less effective in individuals with compromised immunity. The existence of unvaccinated groups represents a significant risk to those with HIV; therefore, researchers evaluated the HBV vaccine response in adults with HIV infection in Brazil. Of the 201 patients evaluated who had a complete vaccination scheme, 55.72% were males and the mean age was 43.86 ± 12.68 years. Vaccine response occurred in 80.10% of patients and did not correlate with age, CD4+ cell count, or viral load.

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“It is important that the HBV vaccine be offered to all HIV-seropositive patients, reinforcing protection, prevention and reduction of costs and damages caused with regard to HBV/HIV coinfection,” concluded the authors.


References
1. Rech-Medeiros AF, dose S. Marcon P, do V. Tovo C, de Mattos AA. Evaluation of response to hepatitis B virus vaccine in adults with human immunodeficiency virus [published online May 25, 2019]. Ann Hepatol. doi:10.1016/j.aohep.2019.03.012

2. Farias N, Souza I, Coelho DM, Oliveira UB, Binelli CA. Co-infection of hepatitis B or C and human immunodeficiency virus: an exploratory study in the State of São Paulo, Brazil, 2007 to 2010. Epidemiol Serv Saude. 2012;21:475-486.

3. Peters PJ, Marston BJ. Preventing deaths in persons with HIV/hepatitis B virus coinfection: a call to accelerate prevention and treatment efforts. J Infect Dis. 2012;205:166-168.

4. Thio CL. Hepatitis B human immunodeficiency virus coinfection. Hepatology. 2009;49:S138-S145.

5. Ferreira MS, Borges AS. Advances in the treatment of hepatitis. Rev Soc Bras Med Trop. 2007;40:451-462.

6. Chun HM, Roediger MP, Hullsiek KH, et al. Hepatitis B virus coinfection negatively impacts HIV outcomes in HIV seroconverters. J Infect Dis. 2012;205:185-193.

7. Thio CL. Hepatitis B in the human immunodeficiency virus-infected patient: epidemiology, natural history, and treatment. Semin Liver Dis. 2003;23:125-136.

8. Abara WE, Qaseem A, Schillie S, McMahon BJ, Harris AM. Hepatitis B vaccination, screening, and linkage to care: best practice advice from the American College of Physicians and the Centers for Disease Control and Prevention. Ann Intern Med. 2017;167:794-804.

9. Allen K, Mesner O, Ganesan A, et al. Association between hepatitis B vaccine antibody response and CD4 reconstitution after initiation of combination antiretroviral therapy in HIV infected persons. BMC. Infect Dis. 2015;15:203-208.

10. Francois CX, Piroth L. Hepatitis B and A vaccination in HIV-infected adults: a review. Hum Vaccin Immunother. 2017;13:1-10.

11. Crum-Cianflone NF, Wallace MR. Vaccination in HIV-infected adults. AIDS. Patient Care STDS. 2014;28:397-410.