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Published on: September 6, 2019
Decreased hepatitis B virus vaccine response among HIV-positive infants compared with HIV-negative infants in
Zachary M Shaver1, Motswedi Anderson1, Lynnette Bhebhe1
1Botswana Harvard AIDS Institute Partnership, Gaborone.
Insights
HIV-positive infants showed a weaker immune response to the hepatitis B vaccine, with lower protective antibody titres. This highlights the need for enhanced strategies to prevent hepatitis B virus transmission from mothers to infants.
Area of Science:
- Immunology
- Virology
- Public Health
Background:
- Hepatitis B virus (HBV) infection poses a significant risk to infants, particularly those born to HIV-positive mothers.
- Understanding vaccine response and HBV prevalence in this vulnerable population is crucial for effective prevention strategies.
Purpose of the Study:
- To determine hepatitis B vaccine antibody titres and the prevalence of hepatitis B surface antigen (HBsAg) in HIV-positive and HIV-negative infants born to HIV-positive mothers in Botswana.
Main Methods:
- A retrospective cross-sectional study analyzed 449 dried blood spot samples from infants (2016-2018).
- Samples were screened for HBsAg, and hepatitis B surface antibody titres were measured.
- Hepatitis B virus (HBV) genotypes were determined via surface gene amplification.
Main Results:
- HIV-positive infants exhibited a significantly lower immune response to the HBV vaccine compared to HIV-negative infants (P < 0.001).
- Protective antibody titres were found in 74.5% of HIV-positive infants versus 89.2% of HIV-negative infants (P < 0.001).
- A low prevalence of HBsAg (0.67%) was observed, with genotype D3 being identified in HBV-positive infants.
Conclusions:
- Vaccine response to hepatitis B is diminished in HIV-positive infants.
- Hepatitis B virus infections occur in both HIV-positive and HIV-negative infants in Botswana.
- Further research into additional preventive measures for mother-to-child HBV transmission is recommended.
Objectives:
We sought to determine vaccine antibody titres and the prevalence of hepatitis B surface antigen (HBsAg) in both HIV-positive and HIV-negative infants born to HIV-positive mothers in Botswana.
Design:
This was a retrospective cross-sectional study using 449 archived dried blood spot samples from both HIV-positive and HIV-negative infants collected between 2016 and 2018.
Methods:
We screened dried blood spot samples for HBsAg and determined hepatitis B surface antibody titres. We determined hepatitis B virus (HBV) genotypes by amplifying 415 base-pairs of the surface region.
Results:
HIV-positive infants mounted a significantly lower immune response to the HBV vaccine (P < 0.001). Furthermore, a lower proportion of HIV-positive infants had protective hepatitis B surface antibody titres (74.5%) than HIV-negative infants (89.2%) (P < 0.001). HIV-positive infants were older and 50.9% of them had completed vaccination (P = 0.018). Of the 449 infant samples tested, three (0.67%) were positive for HBsAg. Of the three HBsAg-positive infants, two had protective titres (>10 mIU/ml). Two of the three HBV-positive infants were infected with genotype D3 and had no drug-resistance or escape mutations.
Conclusion:
Vaccine response was lower among HIV-positive infants compared with HIV-negative infants. HBV infections were observed in both HIV-positive and HIV-negative infants in Botswana. Studies to investigate additional preventive strategies to reduce HBV mother-to-child transmission are recommended.
