ميزان پاسخدهي مناسب به واكشن هپاتسيت B در بيماران HIV مثبت مراجعه كننده به مراكز مشاوره و مراقبت HIV/AIDS استان كرمانشاه

THE RESPONSE TO HEPATITIS B VIRUS VACCINE IN HIV-INFECTED PATIENTS (HIV/AIDS COUNSELLING AND CARE CENTER IN KERMANSHAH)

BACKGROUND AND OBJECTIVE: HBV infection is preventable by effective vaccination in general population, but response to vaccine among HIV infected people seems to be low. METHODS: In this prospective study, 48 HIV positive patients with anti Hbs-Ab and Hbs Ag had hepatitis B vaccination (0,1,6 months). Anti-Hbs levels were measured two months after the last dose by Elisa method. Cellular immunity was evaluated by flocytometry. FINDINGS: Only 14 (29.1%) of vaccinated HIV-infected patients had positive anti-HBs titers (11 males, 3 females). Among them, 4 (28.6%) were over 40 years and from 34 HIV positive patients who did not respond to hepatitis B vaccine, 10 (29.4%) were over 40 years old. The mean number of CD41- T lymphocytes was 352.5 in responders and 283.9 in nonresponders. Two (17.6%) of 17 HIV positive patients with CDT4+<200 and 6 (31.5%) of 19 HIV positive patients with 200500 responded to hepatitis B vaccine. CONCLUSION: Hepatitis B vaccination is better to be administered at the early stage of HIV infection. Conventional dose HIV vaccine is not enough for immunity. Therefore, it is recommended two-fold dose and repeated conventional dose or increasing interval administration of hepatitis B vaccine.