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Vaccination with Fendrix of prior nonresponding patients with HIV has a high success rate

Machiels, Julian D.a,*; Braam, Esmée E.b,*; van Bentum, Petraa; van Vugt, Michèlec; de Vries-Sluijs, Theodora E.M.S.d; Schouten, Ineke W.E.M.e; Bierman, Wouter F.W.f; Gisolf, Elisabeth H.a

doi: 10.1097/QAD.0000000000002085
CLINICAL SCIENCE: CONCISE COMMUNICATIONS

Background: Patients with HIV have a poor serological conversion rate with the standard vaccination strategy against hepatitis B virus (HBV) of around 50%. Vaccination with Fendrix confers much better results in these patients. In this study, we tested the effect of revaccination with Fendrix in prior nonresponding patients with HIV and aimed to determine which factors are associated with seroconversion.

Methods: Eight Dutch HIV treatment centers participated in this retrospective study. Patients infected with HIV-1 and nonresponding to prior course of vaccination against HBV (anti-HBs <10 IU/ml) and who had Fendrix as a second, third or fourth effort to achieve seroconversion were eligible for inclusion. Primary outcome was the proportion of patients with seroconversion after revaccination with Fendrix. Univariate binary logistic regression analyses were used to determine which factors could be used as predictors for seroconversions.

Results: We included 100 patients with HIV. The mean age was 47.3 (±11.0) years and 86% were men. Revaccination with Fendrix showed a seroconversion rate of 81% (95% confidence interval 72–88%). Median nadir CD4+ cell count was 300 (20–1040) cells/μl and median CD4+ cell count at the time at starting vaccination with Fendrix was 605 (210–1190) cells/μl. Regression analyses showed no significant factor associated with seroconversion.

Conclusions: Revaccination with Fendrix of patients prior nonresponding to other hepatitis B vaccination strategies has a high success rate. Eighty-one percentage responded with seroconversion, irrespective of CD4+ cell count.

aRijnstate Arnhem

bUniversity of Groningen, University Medical Center Groningen, Groningen

cAMC Amsterdam

dErasmus MC Rotterdam

eOLVG, Amsterdam

fUniversity Medical Center Groningen, Department of Infectious Diseases, The Netherlands.

Correspondence to Julian D. Machiels, MD, Radboud University Medical Center, Department of Medical Microbiology (777), P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Tel: +31 243614356; e-mail: Julian.machiels@radboudumc.nl

Received 23 August, 2018

Accepted 24 October, 2018

Copyright © 2019 Wolters Kluwer Health, Inc.