Koga Michiko, Senkoji Tomoe, Kubota Megumi, Ishizaka Aya, Mizutani Taketoshi, Sedohara Ayako, Ikeuchi Kazuhiko, Kikuchi Tadashi, Adachi Eisuke, Saito Makoto, Koibuchi Tomohiko, Hosomichi Kazuyoshi, Ohashi Jun, Kawana-Tachikawa Ai, Matano Tetsuro, Tsutsumi Takeya, Yotsuyanagi Hiroshi
Division of Infectious Diseases, Advanced Clinical Research Center, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
Department of Infectious Diseases and Applied Immunology, Hospital of the Institute of Medical Science, University of Tokyo, Tokyo, Japan.
Hepatol Res. 2022 Mar;52(3):227-234. doi: 10.1111/hepr.13736. Epub 2021 Dec 20.
After the hepatitis A virus (HAV) outbreak among men who have sex with men (MSM) around 2018, the importance of HAV vaccination was emphasized, especially for MSM-living with human immunodeficiency virus (MSM-LWHIV). Aimmugen is licensed and distributed exclusively in Japan. While administration of three doses is recommended, 85% of recipients in the general population were reported to acquire seroprotection after the second dose. In this study, we evaluated the efficacy of two or three vaccine doses along with predictors associated with the response to Aimmugen in MSM-LWHIV.
We retrospectively examined anti-HA-IgG titers of MSM-LWHIV vaccinated with Aimmugen in our hospital. Patients' data were collected from medical records.
Between January 2018 and October 2019, 141 subjects whose median age was 46 years old, were examined. All the subjects were on antiretroviral therapy (ART) and the median CD4 count was 615/μL. The acquisition rate of protectable anti-HA-IgG titers after the second and third dose was 71.1% and 98.6%, respectively. In 114 subjects whose anti-HA-IgG titers were tested after the second-dose, factors significantly associated with better response were prolonged ART duration and higher CD4 count. The titers of anti-HA-IgG after the third dose were higher in those who became seropositive after the second-dose than those who did not.
Three-dose of Aimmugen for MSM-LWHIV was effective while two-dose was less effective compared to non-HIV-infected people. People-LWHIV with shorter duration of ART and lesser CD4 cell count achieved lower titers of anti-HA-IgG and might require an additional vaccination.
在2018年前后男男性行为者（MSM）中发生甲型肝炎病毒（HAV）暴发后，HAV疫苗接种的重要性得到了强调，尤其是对于感染人类免疫缺陷病毒的男男性行为者（MSM-LWHIV）。Aimmugen疫苗仅在日本获得许可并销售。虽然建议接种三剂，但据报道，普通人群中85%的接种者在接种第二剂后获得了血清保护。在本研究中，我们评估了两剂或三剂疫苗的效力以及与MSM-LWHIV对Aimmugen疫苗反应相关的预测因素。
我们回顾性检测了在我院接种Aimmugen疫苗的MSM-LWHIV的抗HA-IgG滴度。患者数据从病历中收集。
在2018年1月至2019年10月期间，对141名中位年龄为46岁的受试者进行了检测。所有受试者均接受抗逆转录病毒治疗（ART），中位CD4细胞计数为615/μL。第二剂和第三剂后可检测到的抗HA-IgG滴度的获得率分别为71.1%和98.6%。在114名第二剂后检测抗HA-IgG滴度的受试者中，与更好反应显著相关的因素是ART疗程延长和CD4细胞计数较高。第二剂后血清学阳性者第三剂后的抗HA-IgG滴度高于未血清学阳性者。
对于MSM-LWHIV，三剂Aimmugen疫苗有效，而两剂疫苗的效力低于未感染HIV的人群。ART疗程较短且CD4细胞计数较少的LWHIV人群抗HA-IgG滴度较低，可能需要额外接种疫苗。
