Collier A C, Corey L, Murphy V L, Handsfield H H
University of Washington, Seattle.
Ann Intern Med. 1988 Jul 15;109(2):101-5. doi: 10.7326/0003-4819-109-2-101.
To analyze the relation between human immunodeficiency virus (HIV) infection and the antibody response to plasma-derived hepatitis B vaccine.
Open-label longitudinal cohort study; blinded laboratory studies.
University-affiliated municipal hospital.
Homosexually active men with negative assays for hepatitis B surface antigen (HBsAg), hepatitis B core antigen, and antibody to HBsAg; recruited in a sexually transmitted disease clinic or referred from community practitioners.
Immunization with 20 micrograms of plasma-derived hepatitis B virus vaccine intramuscularly, repeated after 1 and 6 months; standardized evaluation at entry and at 1, 2, 6, and 7 months.
Low antibody response or nonresponse to vaccination occurred in 7 of 16 HIV-seropositive patients, compared with 6 of 68 HIV-seronegative patients (P = 0.002). Median levels of antibody to HBsAg 7 months after the first vaccine dose were 205.3 sample ratio units for HIV-seronegative patients and 15.5 sample ratio units for HIV-seropositive patients. By multivariate analysis, vaccine response was associated with HIV antibody status and not with cytomegalovirus infection, lymphocyte subset results, or impaired cutaneous delayed hypersensitivity.
Infection with HIV is associated with suboptimal antibody response to plasma-derived hepatitis B virus vaccine. Determination of antibody levels after vaccination in HIV-seropositive patients may be warranted.
分析人类免疫缺陷病毒（HIV）感染与对血浆源性乙肝疫苗的抗体反应之间的关系。
开放标签纵向队列研究；实验室盲法研究。
大学附属医院。
乙肝表面抗原（HBsAg）、乙肝核心抗原及抗HBsAg抗体检测均为阴性的男同性恋者；在性传播疾病诊所招募或由社区医生转诊而来。
肌肉注射20微克血浆源性乙肝病毒疫苗，1个月和6个月后重复接种；在入组时以及1、2、6和7个月时进行标准化评估。
16例HIV血清阳性患者中有7例对疫苗的抗体反应低或无反应，而68例HIV血清阴性患者中有6例如此（P = 0.002）。首次接种疫苗7个月后，HIV血清阴性患者抗HBsAg抗体的中位水平为205.3样本比率单位，HIV血清阳性患者为15.5样本比率单位。多因素分析显示，疫苗反应与HIV抗体状态相关，而与巨细胞病毒感染、淋巴细胞亚群结果或皮肤迟发型超敏反应受损无关。
HIV感染与对血浆源性乙肝病毒疫苗的抗体反应欠佳有关。对HIV血清阳性患者接种疫苗后测定抗体水平可能是必要的。
