Key result
Three-dose HAV vaccine linked to ~236% higher 5-year seroprotection odds vs two doses in HIV-positive men.
Why the study?
The durability of serological response to 2 doses of inactivated hepatitis A vaccine is impaired in HIV-1 positive subjects, and it is unclear if 3 doses improve long-term seroprotection.
Does 3 doses of HAV vaccine improve long-term seroprotection in HIV-positive men on antiretroviral therapy compared to 2 doses?
Cohort (n=295)
Does 3 doses of HAV vaccine improve long-term seroprotection in HIV-positive men on antiretroviral therapy compared to 2 doses?
Odds Ratio: 3.36 (95% CI 1.14–9.93)
Absolute Event Rate: 79% vs 76%
p-value: p=> .05
A 3-dose hepatitis A vaccine schedule improves the durability of immune responses compared to a 2-dose schedule in HIV-positive men on antiretroviral therapy.
Three-dose HAV vaccination was associated with sustained higher antibody levels in HIV-positive MSM; leaves open whether it improves clinical protection or warrants schedule changes.
Background: Previous studies have shown that the durability of serological response is impaired in successfully vaccinated human immunodeficiency virus-1 (HIV-1) positive subjects after receiving 2 doses of inactivated hepatitis A virus (HAV) vaccine. We evaluated whether 3 doses compared with 2 doses of HAV vaccine could improve the long-term seroprotection for this susceptible group. Methods: Antibody persistence among HIV-positive men who have sex with men aged 18-40 years who had received 2 or 3 doses of HAV vaccine according to a 0-6- or a 0-1-6-month schedule was evaluated biannually for 5 consecutive years in this prospective, nonrandomized cohort study. Results: At the end of 5 years, seroprotection persisted in 79% (146/185) versus 76% (85/110) and 94% (146/155) versus 88% (84/95) of the 3- versus 2-dose primary responders by intention-to-treat and per-protocol analyses, respectively (P > .05). Throughout the 5 years, the geometric mean concentrations of anti-HAV immunoglobulin G (IgG) were significantly higher for the 3-dose than the 2-dose group. In the multivariable analysis, a 3-dose regimen compared with a 2-dose regimen (odds ratio = 3.36; 95% confidence interval = 1.14-9.93) was independently associated with sustained seroprotection. Conclusions: Three doses versus 2 doses of HAV vaccine improve the durability of immune responses in terms of higher concentrations of specific IgG, which take longer to decay to subthreshold levels.
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Cheng et al. (2016) conducted a cohort in HIV-1 positive (n=295). 3 doses of hepatitis A virus (HAV) vaccine vs. 2 doses of HAV vaccine was evaluated on Sustained seroprotection at 5 years (OR 3.36, 95% CI 1.14-9.93, p=> .05). A 3-dose regimen of HAV vaccine compared with a 2-dose regimen was independently associated with sustained seroprotection at 5 years in HIV-positive men (OR 3.36; 95% CI 1.14-9.93).
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