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Hiv and HepatitisB are interrelated still HepatitisB vaccination lackingin HIV patients resulting in early cirrhosis and tumor -a prevetable disease must be prevented

PROF.DRRAM ,HIV/AIDS,SEX Diseases,Deaddiction & Hepatitis Expert,+917838059592,+919832025033,DELHI,INDIA

Infection with hepatitis B virus (HBV) still constitutes a major public health problem in many countries. More than two billion people have been infected with HBV worldwide, resulting in 240 million chronic carriers. It is estimated that about 780,000 people die annually from complications related to hepatitis B.1 Infection with human immunodeficiency virus (HIV) is also a serious global health problem. About 75 million people have been infected with HIV, with 36 million deaths among individuals with acquired immune deficiency syndrome (AIDS). Globally, there are approximately 35.3 million carriers of HIV.2

Co-infection with HBV and HIV is common.3, 4 and 5 Both viruses share the same risk factors for infection and can be transmitted through parenteral, sexual, and vertical routes.6 In fact, it is estimated that 10% of HIV carriers in the world have chronic hepatitis B.4 The progression of hepatitis B-associated liver disease is particularly modified by HIV co-infection. In HBV/HIV co-infected individuals, the development of chronic hepatitis B is accelerated, with higher risk of cirrhosis and hepatocellular carcinoma development, and increased morbidity and mortality rates.7, 8 and 9 Thus, hepatitis B vaccination in the United States of America is recommended by the Advisory Committee on Immunization Practices (ACIP) for all HIV-infected individuals,10 as a strategy to reduce the public health burden caused by co-infection with these two viruses.

Several studies have shown an impaired antibody response to the standard three doses of 20 μg HBV vaccine of HBV immunization in HIV-infected patients.11, 12 and 13 However, a significant higher seroconversion rate was associated with the administration of double dose of the classic 0, 1 and 6-month schedule hepatitis B vaccination among patients with CD4 cell counts ≥350 cells/mm3 and HIV viral load <10,000 copies/mL.13 A significant increase in the seroconversion rate was also demonstrated in HIV-1 patients using a rapid vaccination schedule of 40 μg HBV vaccine at weeks 0, 4, 8 and 24.14 Furthermore, increased compliance with HBV vaccination was verified among HIV-infected patients who received the accelerated schedule.15

In addition to differences in compliance patterns and antibody responses found with the use of different schedules and antigen concentrations, individual factors are also associated with the success of HBV immunization among HIV carriers.16 In this study, the aim was to evaluate the vaccination coverage and immunity against HBV among HIV-infected patients in South Brazil, as well as to identify factors that are associated with vaccination compliance and antibody reactivity in the studied population and it is found lacking.only 47%vaccinated and level of anti Hbs concentration found low indicate d revaccination.

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