Undetectable Plasma HIV RNA Load Predicts Success after Hepatitis B

Human immunodeficiency virus (HIV)–infected patients re-spond poorly to hepatitis B vaccination. Records of 194 HIV-infected patients were reviewed for factors associated with successful hepatitis B vaccination. Thirty-four patients (17.5%) developed a protective antibody response. In a lo-gistic regression model, only a plasma HIV RNA level of!400 copies/mL at the time of vaccination was associated with a protective antibody response ().Pp.003 HIV and hepatitis B virus (HBV) share routes of transmission; 30%–90 % of HIV-infected patients have evidence of prior HBV infection, and 10 % have chronic infection [1]. With the de-velopment of HAART and with better survival rates, liver dis-ease has become a leading cause of mortality and is of great concern in HIV-HBV–coinfected persons [2]. Although the in-cidence of acute HBV infection is lower among HIV-HBV– coinfected patients than among persons infected with HBV alone, chronic infection occurs more often [3, 4]. Furthermore, coinfection with HIV and HBV was associated with an 8-fold increase in mortality, compared with HIV monoinfection [5]. Therefore, prevention of HBV infection is essential for HIV-infected persons. Unfortunately, HIV-infected patients respond to standard hepatitis B vaccination at rates of 24%–56%, com-pared with rates of 190 % for immunocompetent hosts [6–10]. This study characterizes clinical factors that contribute to vac-cine response. Methods. A retrospective cohort study was conducted at a tertiary care HIV clinic. Institutional review board approva