1504. Association Between Hepatitis B Vaccine Antibody Response and CD4 Reconstitution after Initiation of Combination Antiretroviral Therapy in HIV-Infected Individuals
Session: Poster Abstract Session: HIV and Co-infections
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C

Background:

Hepatitis B (HBV) vaccine antibody response has been associated with reduced risk of AIDS or death. However, the association between HBV vaccine response status and combination antiretroviral therapy (cART) outcomes has been less well studied. We evaluated CD4 gains post-cART according to HBV vaccine antibody response in the U.S. Military HIV Natural History Study.

Methods:

Participants with documented HBV vaccination prior to cART, at least one HBV surface antibody (HBsAb) value after vaccination and before cART, no history of HBV infection, and achievement of viral load <400 copies/mL during the first year of cART were included. HBV vaccine responders were defined as having positive HBsAb while non-responders had negative HBsAb prior to cART.  Participants were further divided by those who received first HBV vaccination prior to HIV infection and those who received first vaccination after HIV infection. Linear mixed regression was used to model CD4 reconstitution within the first year of cART.

Results:

Of the 383 participants whose first HBV vaccine was prior to HIV diagnosis (pre-HIV group), 292 (76.2%) were responders and 91 (23.8%) were non-responders.  Of the 101 participants whose first HBV vaccine was after HIV diagnosis (post-HIV group), 54 (53.5%) were responders and 47 (46.5%) were non-responders. The median CD4 count at cART initiation among the pre-HIV group was 339 [260, 444] cells/uL and did not differ by vaccine response.  Responders in the pre-HIV group increased CD4 counts by 193 [162, 277] cells/uL while non-responders increased by 167 [109, 225] cells/uL during the first year of cART (p=0.369).  Median CD4 at cART initiation among the post-HIV group was 362 [237, 464] cells/uL and was higher among responders (+93 [24, 163] cells/uL; p=0.010).  CD4 response was similar with a median 144 [40, 207] and 165 [108, 222] cells/uL gained during the first year of cART for responders and non-responders, respectively (p=0.631).

Conclusion :

HBV vaccine is a T-cell dependent antigen and while antibody response can provide prognostic information about disease progression and mortality in HIV-infected individuals, HBV vaccine response status was not associated with post-cART CD4 gains at one year among those with virologic suppression.

 

Kahtonna Allen, DO, MS1, Octavio Mesner, MS2, Anuradha Ganesan, MBBS, MPH3, Jessie Glasser, MD, MPH4, Grace E Macalino, PhD2, Brian Agan, MD5 and Jason Okulicz, MD6, (1)Infectious Diseases, Brooke Army Medical Center, Fort Sam Houston, TX, (2)Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Rockville, MD, (3)Infectious Disease Clinical Research Program, Uniformed Services University, Bethesda, MD, (4)Brooke Army Medical Center, San Antonio, TX, (5)Infectious Disease Clin. Research Program, Rockville, MD, (6)Infectious Disease Service, San Antonio Military Medical Center, Fort Sam Houston, TX

Disclosures:

K. Allen, None

O. Mesner, None

A. Ganesan, None

J. Glasser, None

G. E. Macalino, None

B. Agan, None

J. Okulicz, None

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