Management of Vaccination Failure in a Case of HIV -HBV Co-infection: A Case Report
Keywords:HIV Seropositivity, Vaccination, Antigens, Hepatitis B
Background: A 60-year-old African American female patient, with chronic HIV infection since 1999, presented with markers of acute hepatities B virus (HBV) infection for the past 15 months. The patient was previously vaccinated for HBV. Immunoglobulin dysfunction was hypothesized, but electrophoresis yielded no conclusive result.
Results: Investigation suggests that the patient is a non-responder: someone who fails to sero-convert to standard vaccinations. This condition can be linked to B-cell dysfunction due to chronic HIV infection.
Conclusion: It is suggested that non-responders may require a 6-dose regimen to achieve sero-conversion for vaccination. Prevention of co-infection should be the mainstay of treatment, which is achieved by vaccination. However, immune system dysfunction can lead to complications.
2. Thio CL, Seaberg EC, Skolasky R, Phair J, Visscher B, Muñoz A, et al. HIV-1, hepatitis B virus, and risk of liver-related mortality in the Multicenter Cohort Study (MACS). Lancet. 2002;360(9349):1921–6.
3. Rey D, Krantz V, Partisani M, Schmitt MP, Meyer P, Libbrecht E, et al. Increasing the number of hepatitis B vaccine injections augments anti-HBs response rate in HIV-infected patients. Effects on HIV-1 viral load. Vaccine. 2000;18(13):1161–5.
4. Dore GJ, Cooper DA, Pozniak AL, DeJesus E, Zhong L, Miller MD, et al. Efficacy of tenofovir disoproxil fumarate in antiretroviral therapy-naive and -experienced patients coinfected with HIV-1 and hepatitis B virus. J Infect Dis. 2004;189(7):1185–92.
5. Kellerman SE, Hanson DL, McNaghten AD, Fleming PL. Prevalence of chronic hepatitis B and incidence of acute hepatitis B infection in human immunode-ficiency virus-infected subjects. J Infect Dis. 2003;188(4):571–7.
6. Landrum ML, Hullsiek KH, O’Connell RJ, Chun HM, Ganesan A, Okulicz JF, et al. Hepatitis B vaccine antibody response and the risk of clinical AIDS or death. PLoS ONE. 2012;7(3):e33488.
7. Lok AS, McMahon BJ. Chronic hepatitis B: update 2009. Hepatology. 2009;50(3):661–2.
8. Maek-a-Nantawat W, Avihingsanon A, Ohata PJ. Challenges in Providing Treatment and Care for Viral Hepatitis among Individuals Co-Infected with HIV in Resource-Limited Settings. AIDS Res Treat. 2012;2012:948059.
9. Mast EE, Margolis HS, Fiore AE, Brink EW, Goldstein ST, Wang SA, et al. A comprehensive immunization strategy to eliminate transmission of hepati¬tis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) part 1: immunization of infants, children, and adolescents. MMWR Recomm Rep. 2005;54(RR-16):1–31.
10. De Vries-Sluijs TEMS, Hansen BE, van Doornum GJJ, Springeling T, Evertsz NM, de Man RA, et al. A prospective open study of the efficacy of high-dose recombinant hepatitis B rechallenge vaccination in HIV-infected patients. J Infect Dis. 2008;197(2):292-4.
11. Quaglio G, Lugoboni F, Mezzelani P, Des Jarlais DC, Lechi A. Hepatitis vac¬cination among drug users. Vaccine. 2006;24(15):2702-9.
12. Buckner CM, Kardava L, Moir S. Evaluation of B cell function in patients with HIV. Curr Protoc Immunol. 2013;Chapter 12:Unit 12.13.
13. Moir S, Fauci AS. Pathogenic mechanisms of B-lymphocyte dysfunction in HIV disease. J Allergy Clin Immunol. 2008;122(1):12-9.
14. CDC - Centers for Disease Control and Prevention. Guidelines for the Pre¬vention and Treatment of Opportunistic Infections Among HIV-Exposed and HIV-Infected Children. CDC - Morb Mortal Wkly Repor. 2009;58:1–176.
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