Management of Vaccination Failure in a Case of HIV -HBV Co-infection: A Case Report
Background: A 60-year-old African American female patient, with chronic HIV infection since 1999, presented with markers of acute hepatities B virus (HBV) infection for the past 15 months. The patient was previously vaccinated for HBV. Immunoglobulin dysfunction was hypothesized, but electrophoresis yielded no conclusive result. Results: Investigation suggests that the patient is a non-responder: someone who fails to sero-convert to standard vaccinations. This condition can be linked to B-cell dysfunction due to chronic HIV infection. Conclusion: It is suggested that non-responders may require a 6-dose regimen to achieve sero-conversion for vaccination. Prevention of co-infection should be the mainstay of treatment, which is achieved by vaccination. However, immune system dysfunction can lead to complications.
2. Thio CL, Seaberg EC, Skolasky R, Phair J, Visscher B, Muñoz A, et al. HIV-1, hepatitis B virus, and risk of liver-related mortality in the Multicenter Cohort Study (MACS). Lancet. 2002;360(9349):1921–6.
3. Rey D, Krantz V, Partisani M, Schmitt MP, Meyer P, Libbrecht E, et al. Increasing the number of hepatitis B vaccine injections augments anti-HBs response rate in HIV-infected patients. Effects on HIV-1 viral load. Vaccine. 2000;18(13):1161–5.
4. Dore GJ, Cooper DA, Pozniak AL, DeJesus E, Zhong L, Miller MD, et al. Efficacy of tenofovir disoproxil fumarate in antiretroviral therapy-naive and -experienced patients coinfected with HIV-1 and hepatitis B virus. J Infect Dis. 2004;189(7):1185–92.
5. Kellerman SE, Hanson DL, McNaghten AD, Fleming PL. Prevalence of chronic hepatitis B and incidence of acute hepatitis B infection in human immunode-ficiency virus-infected subjects. J Infect Dis. 2003;188(4):571–7.
6. Landrum ML, Hullsiek KH, O’Connell RJ, Chun HM, Ganesan A, Okulicz JF, et al. Hepatitis B vaccine antibody response and the risk of clinical AIDS or death. PLoS ONE. 2012;7(3):e33488.
7. Lok AS, McMahon BJ. Chronic hepatitis B: update 2009. Hepatology. 2009;50(3):661–2.
8. Maek-a-Nantawat W, Avihingsanon A, Ohata PJ. Challenges in Providing Treatment and Care for Viral Hepatitis among Individuals Co-Infected with HIV in Resource-Limited Settings. AIDS Res Treat. 2012;2012:948059.
9. Mast EE, Margolis HS, Fiore AE, Brink EW, Goldstein ST, Wang SA, et al. A comprehensive immunization strategy to eliminate transmission of hepati¬tis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) part 1: immunization of infants, children, and adolescents. MMWR Recomm Rep. 2005;54(RR-16):1–31.
10. De Vries-Sluijs TEMS, Hansen BE, van Doornum GJJ, Springeling T, Evertsz NM, de Man RA, et al. A prospective open study of the efficacy of high-dose recombinant hepatitis B rechallenge vaccination in HIV-infected patients. J Infect Dis. 2008;197(2):292-4.
11. Quaglio G, Lugoboni F, Mezzelani P, Des Jarlais DC, Lechi A. Hepatitis vac¬cination among drug users. Vaccine. 2006;24(15):2702-9.
12. Buckner CM, Kardava L, Moir S. Evaluation of B cell function in patients with HIV. Curr Protoc Immunol. 2013;Chapter 12:Unit 12.13.
13. Moir S, Fauci AS. Pathogenic mechanisms of B-lymphocyte dysfunction in HIV disease. J Allergy Clin Immunol. 2008;122(1):12-9.
14. CDC - Centers for Disease Control and Prevention. Guidelines for the Pre¬vention and Treatment of Opportunistic Infections Among HIV-Exposed and HIV-Infected Children. CDC - Morb Mortal Wkly Repor. 2009;58:1–176.
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site; with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from the Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Enforcement of copyright
The IJMS takes the protection of copyright very seriously.
If the IJMS discovers that you have used its copyright materials in contravention of the license above, the IJMS may bring legal proceedings against you seeking reparation and an injunction to stop you using those materials. You could also be ordered to pay legal costs.
If you become aware of any use of the IJMS' copyright materials that contravenes or may contravene the license above, please report this by email to email@example.com
If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to firstname.lastname@example.org