ASHM Report Back
Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.
Hepatitis B vax - 3 is enough
Chaiklang et al conducted a randomized trial in Thailand, in 132 HIV+ adults who were HBV– and had CD4 cell count of >200 cells/μL and undetectable viral load of 3 different hepatitis B vaccine schedules.
Patients were 1:1:1 randomly assigned to receive a standard vaccination (20 μg intramuscularly at month 0, 1, and 6 or 20 μg IM at month 0, 1, 2, and 6 or 40 μg IM at month 0, 1, 2, and 6. .Responders were patients who had hepatitis B surface antibody (anti-HBs) of at least 10 mIU/mL) at month 7.
The percentage of responders at month 7 was 88.6 in the IM 20x3 group, 93.2 in the IM 20x4 group (p = 0.458 vs IM 20x3 group), and 95.5% in the IM 40x4 group (p = 0.237 vs IM 20x3 group).
The standard HBV vaccination in HIV+ adults with CD4 cell counts >200 cells/μL and undetectable viral load is highly effective. Regimens of 4 injections of either standard or double doses may increase the response rate and induce higher level of protective antibody.