Effect of Antiretroviral Therapy on Immunological Response to Hepatitis B Vaccine in HIV Infected Children Addis Ababa, Ethiopia
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Date
2015-09
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Addis Ababa University
Abstract
Introduction: Hepatitis B virus (HBV) infection causes worldwide problem and the
complication varies from acute liver failure to hepatocellular carcinoma. A vaccine is available to
prevent HBV infection, however reduced vaccine response were reported among HIV infected
individuals. The information on effect of ART on childhood response to HBV vaccine is
fragmented and there is no different vaccination schedules for HIV positive children.
Objective: To assess the impact of HIV-1 infection and effect of antiretroviral drug therapy on
the immune response to Hepatitis B vaccine and phenotypic property of B cells in children in
Addis Ababa, Ethiopia
Methods: Longitudinal Cohort study was conducted from January, 2015 to June, 2015. Children,
5-9 years of age, from the Pediatric department of ALERT and Zewuditu Memorial Hospital, in
Addis Ababa, Ethiopia were screened for HBV infection and standard hepatitis B vaccine was
given to those children with no HBV infection at 0, 4 and 8 weeks. The vaccine response was
evaluated by measuring Hepatitis B surface antibody(HBsAb) by ELISA and B cells phenotypic
characterization using flowcytometry before and after vaccination.
Results: All healthy controls and 94 % of HIV positive children responded to hepatitis B
vaccine. Plasma level of hepatitis B surface antibody was significantly reduced in HIV-1 positive
children than healthy controls (p= 0.0001). Higher vaccine response was observed in early ART
treated children (r=-0.3497,p=0.0046). The frequency of Resting Memory B cells showed no
increment in HIV positive children (p>0.05) while significantly increased in healthy controls
(p<0.0001), and the frequency of Activated Memory B cells decreased in HIV positive
children(p<0.001) and increased in healthy controls (p<0.05) after vaccination.
Conclusion and Recommendation: Our results showed reduced plasma antibody level and low
frequency of RM B cells in HIV positive children. Therefore, regular monitoring of plasma
antibody level to HBV vaccine should be integrated for HIV infected children and booster dose
of HBV vaccine would be planned, irrespective of ART status.
Key Words: HBV, antibody response, HBsAb, B cells, ART
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Keywords
HBV; Antibody response; HBsAb, B cells; ART