The Prevalence of Co-infection with Hepatitis Viruses in Human Immunodeficiency Virus (HIV) Infected Patients in Japan and the Efficacy of Hepatitis B Virus (HBV) /Hepatitis A Virus (HAV) Vaccination

Abstract

Objective : To reveal the prevalence of co-infection with hepatitis viruses in HIV infected patients in Japan. The second objective was to assess the efficacy of HBV and/or HAV vaccination in HIV infected subjects' who are considered eligible for vaccination.
Methods : We studied 263 sexually transmitted HIV infected patients (254 male and 9 female subjects) who were over 16 years old. HBV seronegative patients received the threedose regimen of recombinant HBV vaccine (Bimmugen(R), Kaketsuken) and HAV seronegative patients received the three-dose regimen of tissue cultured HAV vaccine (Aimmugen(R), Katetsuken). After vaccination, anti-HBs and anti-HA levels were estimated in the serum by enzyme-linked immunosorbent assay (ELISA).
Results : Seventeen patients (6.5%) were positive for HBsAg. HBs and HA seropositive subjects were 154 (59%) and 50 (20%) patients respectively. And 4 patients (1.5%) were seropositive for hepatitis C virus (HCV). After three doses of vaccine in seronegative subjects, the overall HBV and HAV eroconversion rates were 43 % and 97%, respectively. Though the mean CD4 cell count (183/mm3) of HAV vaccination non-responders was statistically lower than that (451/mm3) of responders, there was no statistical difference in the levels of CD4 cell counts between responders and non-responders (mean CD4 cell counts were 567/mm3 and 463/mm3, respectively) of HBV vaccination.
Conclusion : Although the number of subjects was small and the duration of observation was short, no relationship was found between CD4 levels and immune responses after HBV vaccination. Thus HBV/HAV vaccination should be provided to all HIV infected patients at any stage who are considered eligible for vaccination, considering that the medication for co-infected patients is troublesome and the routes of transmission are shared.