Patterson Shane B, Landrum Michael L, Okulicz Jason F
Department of Medicine, Division of Internal Medicine, San Antonio Military Medical Center, Fort Sam Houston, TX, United States.
Bellin Health, Green Bay, WI, United States.
Vaccine. 2014 Jun 5;32(27):3341-4. doi: 10.1016/j.vaccine.2014.04.049. Epub 2014 Apr 29.
Delayed-type hypersensitivity (DTH) test responsiveness is associated with HIV disease progression; however it is unknown whether other immune markers, such as hepatitis B virus (HBV) vaccine seroresponse, also predict HIV outcomes.
Eligible participants received HBV vaccine after HIV diagnosis, had non-anergic DTH testing at the time of last HBV vaccination, and available post-vaccine HBV antibody responses. The risk of progression to AIDS or death from the time of last HBV vaccination was evaluated.
Of 369 eligible participants with non-anergic DTH responses, 148 (40%) were HBV vaccine responders. In a multivariate model adjusted for age, CD4 count, viral load, and number of vaccinations, HBV vaccine non-responders had an increased risk of progression to AIDS or death (HR 1.81; 95% CI, 1.03-3.19).
HBV vaccine seroresponses were independent of DTH responses which suggest that non-response to HBV vaccine is not solely due to cell-mediated immune dysfunction in HIV-infected persons.
迟发型超敏反应（DTH）测试反应性与HIV疾病进展相关；然而，其他免疫标志物，如乙肝病毒（HBV）疫苗血清反应，是否也能预测HIV的转归尚不清楚。
符合条件的参与者在HIV诊断后接种HBV疫苗，在最后一次接种HBV疫苗时进行非无反应性DTH测试，并获得疫苗接种后的HBV抗体反应。评估了自最后一次接种HBV疫苗起进展为艾滋病或死亡的风险。
在369名具有非无反应性DTH反应的符合条件的参与者中，148名（40%）为HBV疫苗应答者。在根据年龄、CD4细胞计数、病毒载量和接种次数进行调整的多变量模型中，HBV疫苗无应答者进展为艾滋病或死亡的风险增加（风险比1.81；95%置信区间，1.03 - 3.19）。
HBV疫苗血清反应独立于DTH反应，这表明HIV感染者对HBV疫苗无应答并非完全归因于细胞介导的免疫功能障碍。
