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HBV vaccination in HIV-positive, HBVcAb-positive patients
Morsica et al 1 looked at 25 HIV-positive patients with isolated antibodies to hepatitis B core antigen (HBVcAb). The 25 patients, 80% male and 50% intravenous drug users, were tested at baseline and then vaccinated for hepatitis B and their response was monitored. Those with hepatitis B surface antibody <100 IU/L continued to have the full vaccination course with subsequent vaccines at weeks 5 and 24. Antibody titres were measured for all patients at baseline, and at 4 (postvaccination) 24 and 48 weeks. In addition hepatitis B virus (HBV) DNA quantification was also taken at these time points and hepatitis C antibody status was measured.
Their results show that 6/25 (24%) developed an antibody response and 4/6 had anti-HBs levels of >100 IU/L. Of the 19 remaining patients, 10 (52.6%) developed adequate immunity (>10 IU/L) after the third vaccine dose. Occult HBV infection was seen in four out of six patients who developed an antibody response after one vaccine, in two out of ten patients with …
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