Immune Responses to HBV Vaccine in People Living with HIV (PLWHs) Who Achieved Successful Treatment: A Prospective Cohort Study

成功接受治疗的艾滋病毒感染者对乙肝疫苗的免疫反应:一项前瞻性队列研究

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Abstract

BACKGROUND: Understanding immune responses after HBV vaccination is important to prevent HBV infection in PLWH and to achieve successful treatment. METHODS: Thirty-two PLWHs with CD4(+) cell count > 350 cells/µL and HIV RNA < 200 copies/mL were vaccinated with 20 µg of HBV vaccine at weeks 0, 4, and 24 in this prospective study. We measured total HIV DNA levels, HBsAb titers and HBsAg-specific T-cell responses during follow-up time. RESULTS: All patients achieved protective HBsAb titer after immunization. The magnitude of the IFN-r and TNF-a response to HBsAg was 22.0 (IQR: 6.5-65.0) and 106.50 (IQR: 58.5-203.0) spot-forming cells (SFC)/10(5) PBMC, respectively at week 0. The level of IFN-r secreted at weeks 12 and weeks 36 to 48 was comparable with that at week 0. However, IFN-r response was higher at weeks 12 than that at weeks 36 to 48 (p = 0.02). The level of TNF-a secreted at weeks 12 was higher than that at week 0 (p < 0.001). Total HIV DNA levels were 2.76 (IQR: 2.47-3.07), 2.77 (IQR: 2.50-3.09), 2.77 (IQR: 2.41-2.89) log(10) copies/10(6) PBMCs at weeks 0, 12, 36 to 48, respectively. No correlation was observed between IFN-r and TNF-a levels and HBsAb titer as well as total HIV DNA levels after immunization. CONCLUSION: Humoral immunity was satisfactory, but cellular immunity and decline in HIV reservoir were not optimal after HBV vaccine immunization in these patients.

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