Sustainability of Imune Response To Hepatitis B Virus Vaccination 3 years post Vaccination among HIV-1 infected and Uninfected adults in Kenya

Abstract

Background: Hepatitis B virus (HBV) infection, a leading cause of chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma worldwide is preventable by vaccination. Completion of recommended vaccination over 90% of adults develops protective anti-Hbs antibodies levels. However, there’s paucity of data on sustained immune response to HBV vaccine among HIV infected African adults. A retrospective study was conducted and analysed 336 archived serum samples collected 3-years post HBV vaccination from participants enrolled in the Partners PrEP study, for Hepatitis B surface antibody (anti-Hbs) using ELISA.Samples that didn’t have protective anti-Hbs titers were further tested for Hepatitis B surface antigen (HBsAg). Univariate logistic regression was used to determine factors associated with non-response. Of the 336 samples tested, 176 (52.4%) were from HIV-1 infected, 40 (22.7%) were male. 160 samples from HIV-1 uninfected, 125 (78.1%) were male. The mean (standard deviation) age of the study population was 34.6 (8.5) years. Of the 62 (18%) who didn’t have protective anti-Hbs titers, 50 (81%) were HIV-1 infected. HIV infected were more likely to have less protective anti-Hbs titers (p<0.001) compared to HIV uninfected. Compared to men, women were more likely not to have protective anti-Hbs levels (11.5% vs. 25.1%, p=0.002). Seven (11.3%) of the 62 samples that didn’t have protective anti-Hbs titres, also tested positive for HBsAg, all were HIV-1 infected. More than a quarter of HIV infected vaccinated against HBV didn’t have protective anti-Hbs titres, some acquired HBV infection. Regular testing for immune response to HBV vaccination among HIV infected should be considered.