Evaluation of the Intensity of Post-Vaccination Immunity to Hepatitis B among HIV-infected and Conditionally Healthy Persons in Western Siberia

M. Kartashov, K. A. Svirin, E. I. Krivosheina, E. Chub, V. Ternovoi, G. V. Kochneva
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Abstract

Relevance. Hepatitis B often causes liver cirrhosis and hepatocellular carcinoma, especially among patients with HIV. Vaccination is the main prophylaxis of HBV for preventing infection and developing chronic disease. Studying the duration of postvaccination immunity and the expediency of revaccination in different age and risk groups is important for improving the strategy of immunoprophylaxis of B hepatitis.Aims. Study was to determine the level of post-vaccination immunity to HBV and specific antibodies (anti-HBc and anti-HBs) among HIV-positive patients and the healthy population of Novosibirsk and Tomsk.Materials and methods. 536 blood samples were taken from HIV-positive patients and 337 blood samples from healthy people (pregnant women and persons undergoing a routine medical examination). The presence of HBsAg, anti-HBs IgG, and anti-HBcIgG were determined in the samples.Results. The proportion of post-vaccination immunity decreased in older age groups with an increase in the proportion of post-exposure immunity. The proportion of HIV-positive patients who had contact with HBV was higher than among healthy people. Around 70% of people in each group had a low level of protective antibodies anti-HBs (lower than 100 IU). A high level of anti-HBs (higher than 400 IU) was determined in 10% of examined people. The proportion of low levels of anti-HBs increased with age, while average and high levels of post-vaccination immunity were less common with increasing age.Conclusion. A low proportion of HIV-positive people, who have been effectively vaccinated against hepatitis B, was noticed. Annual blood tests for the presence of HBsAg, anti-HBs, and anti-HBc, in combination with determining DNA HBV, can be recommended for HIV-positive patients who have a risk of developing an occult form of hepatitis B.
评估西西伯利亚艾滋病毒感染者和条件健康者接种乙型肝炎疫苗后的免疫强度
相关性。乙型肝炎通常会导致肝硬化和肝细胞癌,尤其是在艾滋病毒感染者中。接种疫苗是预防乙型肝炎病毒感染和慢性疾病的主要方法。研究不同年龄和风险群体接种疫苗后免疫力的持续时间以及再次接种疫苗的适宜性,对于改进乙型肝炎免疫预防策略非常重要。研究旨在确定新西伯利亚和托木斯克的 HIV 阳性患者和健康人群接种疫苗后对 HBV 的免疫水平以及特异性抗体(抗 HBc 和抗 HBs)。536 份血液样本来自艾滋病病毒阳性患者,337 份血液样本来自健康人群(孕妇和接受常规体检者)。结果显示,接种疫苗后免疫力下降的比例比接种疫苗前下降的比例要高。接种疫苗后免疫的比例在年龄越大的人群中越低,而暴露后免疫的比例则越高。曾接触过 HBV 的 HIV 阳性患者比例高于健康人群。每组中约有 70% 的人的抗 HBs 保护性抗体水平较低(低于 100 IU)。10%的受检者的抗-HBs 水平较高(高于 400 IU)。低水平抗-HBs的比例随着年龄的增长而增加,而平均水平和高水平的接种后免疫力则随着年龄的增长而降低。我们注意到,HIV 阳性者中有效接种过乙型肝炎疫苗的比例较低。建议有隐匿性乙型肝炎风险的 HIV 阳性患者每年抽血检测 HBsAg、抗-HBs 和抗-HBc,同时检测 DNA HBV。
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