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. 2011 Jun 15;203(12):1815-23.
doi: 10.1093/infdis/jir180.

Long-term durability of immune responses after hepatitis A vaccination among HIV-infected adults

Nancy F Crum-Cianflone  1 , Kenneth Wilkins, Andrew W Lee, Anthony Grosso, Michael L Landrum, Amy Weintrob, Anuradha Ganesan, Jason Maguire, Stephanie Klopfer, Carolyn Brandt, William P Bradley, Mark R Wallace, Brian K Agan; Infectious Disease Clinical Research Program HIV Working Group
Collaborators, Affiliations

Long-term durability of immune responses after hepatitis A vaccination among HIV-infected adults

Nancy F Crum-Cianflone et al. J Infect Dis. .

Abstract

Background: Vaccination provides long-term immunity to hepatitis A virus (HAV) among the general population, but there are no such data regarding vaccine durability among human immunodeficiency virus (HIV)-infected adults.

Methods: We retrospectively studied HIV-infected adults who had received 2 doses of HAV vaccine. We analyzed blood specimens taken at 1 year, 3 years, and, when available, 6-10 years postvaccination. HAV immunoglobulin G (IgG) values of ≥10 mIU/mL were considered seropositive.

Results: We evaluated specimens from 130 HIV-infected adults with a median age of 35 years and a median CD4 cell count of 461 cells/mm(3) at or before time of vaccination. Of these, 49% had an HIV RNA load <1000 copies/mL. Initial vaccine responses were achieved in 89% of HIV-infected adults (95% confidence interval [CI], 83%-94%), compared with 100% (95% CI, 99%-100%) of historical HIV-uninfected adults. Among initial HIV-infected responders with available specimens, 90% (104 of 116; 95% CI, 83%-95%) remained seropositive at 3 years and 85% (63 of 74; 95% CI, 75%-92%) at 6-10 years. Geometric mean concentrations (GMCs) among HIV-infected adults were 154, 111, and 64 mIU/mL at 1, 3, and 6-10 years, respectively, compared with 1734, 687, and 684 mIU/mL among HIV-uninfected persons. Higher GMCs over time among HIV-infected adults were associated with lower log(10) HIV RNA levels (β = -.12, P = .04).

Conclusions: Most adults with well-controlled HIV infections had durable seropositive responses up to 6-10 years after HAV vaccination. Suppressed HIV RNA levels are associated with durable HAV responses.

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Figures

Figure 1.
Figure 1.
Post–HAV vaccination geometric mean concentrations of antibody responses in HIV-infected persons stratified by CD4 cell count and plasma HIV RNA level at time of vaccination [42, 43].
See this image and copyright information in PMC

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