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J Infect Dis. 2016 Jun 1;213(11):1735-42. doi: 10.1093/infdis/jiw011. Epub 2016 Jan 14.

Vaccination Against Hepatitis B Virus (HBV) in HIV-1-Infected Patients With Isolated Anti-HBV Core Antibody: The ANRS HB EP03 CISOVAC Prospective Study.

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Département d'infectiologie, CHU de Dijon, MERS UMR1347, Université de Bourgogne, Dijon Cedex.
Université Paris Descartes, Sorbonne Paris Cité; INSERM, CIC 1417 , F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Cochin, CIC Cochin Pasteur.
Laboratoire de Pathogenèse des virus de l'hépatite B, Département de Virologie, Institut Pasteur, INSERM U994, Paris.
INSERM, CIC 1432, Centre d'investigation clinique (Epidémiologie clinique/ essais cliniques), CHU de Dijon.
Département des Maladies Infectieuses, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, INSERM U1052.
Service des Maladies Infectieuses, CHU de Tourcoing.
Service des Maladies Infectieuses, CHU de Besançon, Université de Franche-Comté
Service de Médecine Interne, Hôpital Foch,Suresnes.
Laboratoire de Virologie, Hôpitaux Universitaires, Strasbourg.
INSERM, UMR S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique Sorbonne Universités, UPMC Univ Paris 06, UMR S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique Public Health Unit, Saint-Antoine Hospital, AP-HP, Paris.
Center for HIV infection care, Hôpitaux Universitaires, Strasbourg Cedex, France.



Although an isolated anti-hepatitis B virus (HBV) core antibody (anti-HBc) serological profile is frequent in human immunodeficiency virus (HIV)-infected patients, data on HBV vaccination in these patients are scarce.


A prospective multicenter study was conducted to assess the immunogenicity of HBV vaccination in 54 patients with an isolated anti-HBc profile and undetectable HIV load. They were vaccinated with 1 dose (20 µg) of recombinant HBV vaccine. Those with an anti-HBV surface antibody (anti-HBs) level of <10 mIU/mL 4 weeks after vaccination received 3 additional double doses (40 µg) at weeks 5, 9, and 24.


At week 4, 25 patients (46%) were responders. Only the ratio of CD4(+) T cells to CD8(+) T cells was associated with this response in multivariate analysis (odds ratio for +0.1, 1.32; 95% confidence interval, 1.07-1.63; P = .008). At week 28 and month 18, 58% of these patients (14 of 24) and 50% (10 of 20), respectively, maintained anti-HBs level of ≥10 mIU/mL.Among nonresponding patients at week 4, who received further vaccinations, 89% (24 of 27) and 81% (21 of 26) had an anti-HBs level of ≥10 mIU/mL at week 28 and month 18, respectively. The preS2-specific interferon γ T-cell response increased between week 0 and week 28 in patients who finally responded to reinforced vaccination (P = .03).


All of the patients with an isolated anti-HBc profile who did not have an anti-HBs titer of >100 mIU/mL 4 weeks after a single recall dose of HBV vaccine should be further vaccinated with a reinforced triple double-dose scheme.


HBV; HIV; immunology; isolated anti-HBc; vaccination

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