Hepatitis B virus prevalence and vaccine response in HIV-infected children and adolescents on combination antiretroviral therapy in Kigali, Rwanda

Philippe R. Mutwa; Kimberly R. Boer; John B. Rusine; Narcisse Muganga; Diane Tuyishimire; Peter Reiss; Joep Ma Lange; Sibyl P.M. Geelen

doi:10.1097/INF.0b013e318271b93d

Hepatitis B virus prevalence and vaccine response in HIV-infected children and adolescents on combination antiretroviral therapy in Kigali, Rwanda

Philippe R. Mutwa^*, Kimberly R. Boer, John B. Rusine, Narcisse Muganga, Diane Tuyishimire, Peter Reiss, Joep Ma Lange, Sibyl P.M. Geelen

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

11 Citations (Scopus)

Abstract

Objective: The aim of this study was to determine the prevalence of hepatitis B virus (HBV) infection in a cohort of HIV-infected Rwandan children and adolescents on combination antiretroviral therapy (cART), and the success rate of HBV vaccination in those children found to be HBV negative. Methods: HIV-infected children and adolescents (age 8-17 years) receiving cART with CD4 T-cells count ≥200 cells/mm³ and/or ≥15% and without prior HBV vaccination (by history, vaccination cards and clinic records) underwent serologic testing for past (negative HBV surface antigen [HBsAg] with positive antibody to HBV core antigen [cAb] and to HBsAg [anti-HBs]) or active HBV infection (positive HBsAg). Children with any positive HBV serologic tests were excluded from further vaccination; all others completed 3 HBV immunizations with 10 μg of ENGERIX-B. Anti-HBs titer was measured 4-6 weeks after the last immunization. Results: Of 88 children, 6 (7%) children had active HBV infection and 8 (9%) had past HBV infection. The median (interquartile range) age, CD4 T-cell count and cART duration were 12.3 (10.1-13.9) years, 626 (503 to 942) cells/mm³ and 1.9 (1.5-2.7) years, respectively. Seventeen children had detectable plasma HIV-1 RNA. Seventy-3 children completed 3 immunizations with median (interquartile range) postimmunization anti-HBs concentration of 151 mlU/mL (1.03-650). Overall, 52 children (71%, 95% confidence interval: 61-82) developed a protective anti-HBs response. HIV-1 RNA and CD4 T-cell count were independent predictors of a protective anti-HBs response. Protective anti-HBs response was achieved in 82% of children with undetectable HIV-1 RNA and 77% with CD4 T cells >350/mm³. Conclusions: The substantial HBV prevalence in this cohort suggests that HIV-infected Rwandan children should be screened for HBV before cART initiation. HIV viral suppression and CD4 T cells ≥350/mm³ favored the likelihood of a protective response after HBV vaccination.

Original language	English
Pages (from-to)	246-251
Number of pages	6
Journal	Pediatric Infectious Disease Journal
Volume	32
Issue number	3
DOIs	https://doi.org/10.1097/INF.0b013e318271b93d
Publication status	Published - 1 Mar 2013

Keywords

Hepatitis B
HIV-infected children and adolescents
Rwanda

Access to Document

10.1097/INF.0b013e318271b93d

Cite this

Mutwa, P. R., Boer, K. R., Rusine, J. B., Muganga, N., Tuyishimire, D., Reiss, P., Lange, J. M., & Geelen, S. P. M. (2013). Hepatitis B virus prevalence and vaccine response in HIV-infected children and adolescents on combination antiretroviral therapy in Kigali, Rwanda. Pediatric Infectious Disease Journal, 32(3), 246-251. https://doi.org/10.1097/INF.0b013e318271b93d

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title = "Hepatitis B virus prevalence and vaccine response in HIV-infected children and adolescents on combination antiretroviral therapy in Kigali, Rwanda",

abstract = "Objective: The aim of this study was to determine the prevalence of hepatitis B virus (HBV) infection in a cohort of HIV-infected Rwandan children and adolescents on combination antiretroviral therapy (cART), and the success rate of HBV vaccination in those children found to be HBV negative. Methods: HIV-infected children and adolescents (age 8-17 years) receiving cART with CD4 T-cells count ≥200 cells/mm3 and/or ≥15% and without prior HBV vaccination (by history, vaccination cards and clinic records) underwent serologic testing for past (negative HBV surface antigen [HBsAg] with positive antibody to HBV core antigen [cAb] and to HBsAg [anti-HBs]) or active HBV infection (positive HBsAg). Children with any positive HBV serologic tests were excluded from further vaccination; all others completed 3 HBV immunizations with 10 μg of ENGERIX-B. Anti-HBs titer was measured 4-6 weeks after the last immunization. Results: Of 88 children, 6 (7%) children had active HBV infection and 8 (9%) had past HBV infection. The median (interquartile range) age, CD4 T-cell count and cART duration were 12.3 (10.1-13.9) years, 626 (503 to 942) cells/mm3 and 1.9 (1.5-2.7) years, respectively. Seventeen children had detectable plasma HIV-1 RNA. Seventy-3 children completed 3 immunizations with median (interquartile range) postimmunization anti-HBs concentration of 151 mlU/mL (1.03-650). Overall, 52 children (71%, 95% confidence interval: 61-82) developed a protective anti-HBs response. HIV-1 RNA and CD4 T-cell count were independent predictors of a protective anti-HBs response. Protective anti-HBs response was achieved in 82% of children with undetectable HIV-1 RNA and 77% with CD4 T cells >350/mm3. Conclusions: The substantial HBV prevalence in this cohort suggests that HIV-infected Rwandan children should be screened for HBV before cART initiation. HIV viral suppression and CD4 T cells ≥350/mm3 favored the likelihood of a protective response after HBV vaccination.",

keywords = "Hepatitis B, HIV-infected children and adolescents, Rwanda",

author = "Mutwa, {Philippe R.} and Boer, {Kimberly R.} and Rusine, {John B.} and Narcisse Muganga and Diane Tuyishimire and Peter Reiss and Lange, {Joep Ma} and Geelen, {Sibyl P.M.}",

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Hepatitis B virus prevalence and vaccine response in HIV-infected children and adolescents on combination antiretroviral therapy in Kigali, Rwanda. / Mutwa, Philippe R.; Boer, Kimberly R.; Rusine, John B. et al.
In: Pediatric Infectious Disease Journal, Vol. 32, No. 3, 01.03.2013, p. 246-251.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Hepatitis B virus prevalence and vaccine response in HIV-infected children and adolescents on combination antiretroviral therapy in Kigali, Rwanda

AU - Mutwa, Philippe R.

AU - Boer, Kimberly R.

AU - Rusine, John B.

AU - Muganga, Narcisse

AU - Tuyishimire, Diane

AU - Reiss, Peter

AU - Lange, Joep Ma

AU - Geelen, Sibyl P.M.

PY - 2013/3/1

Y1 - 2013/3/1

N2 - Objective: The aim of this study was to determine the prevalence of hepatitis B virus (HBV) infection in a cohort of HIV-infected Rwandan children and adolescents on combination antiretroviral therapy (cART), and the success rate of HBV vaccination in those children found to be HBV negative. Methods: HIV-infected children and adolescents (age 8-17 years) receiving cART with CD4 T-cells count ≥200 cells/mm3 and/or ≥15% and without prior HBV vaccination (by history, vaccination cards and clinic records) underwent serologic testing for past (negative HBV surface antigen [HBsAg] with positive antibody to HBV core antigen [cAb] and to HBsAg [anti-HBs]) or active HBV infection (positive HBsAg). Children with any positive HBV serologic tests were excluded from further vaccination; all others completed 3 HBV immunizations with 10 μg of ENGERIX-B. Anti-HBs titer was measured 4-6 weeks after the last immunization. Results: Of 88 children, 6 (7%) children had active HBV infection and 8 (9%) had past HBV infection. The median (interquartile range) age, CD4 T-cell count and cART duration were 12.3 (10.1-13.9) years, 626 (503 to 942) cells/mm3 and 1.9 (1.5-2.7) years, respectively. Seventeen children had detectable plasma HIV-1 RNA. Seventy-3 children completed 3 immunizations with median (interquartile range) postimmunization anti-HBs concentration of 151 mlU/mL (1.03-650). Overall, 52 children (71%, 95% confidence interval: 61-82) developed a protective anti-HBs response. HIV-1 RNA and CD4 T-cell count were independent predictors of a protective anti-HBs response. Protective anti-HBs response was achieved in 82% of children with undetectable HIV-1 RNA and 77% with CD4 T cells >350/mm3. Conclusions: The substantial HBV prevalence in this cohort suggests that HIV-infected Rwandan children should be screened for HBV before cART initiation. HIV viral suppression and CD4 T cells ≥350/mm3 favored the likelihood of a protective response after HBV vaccination.

AB - Objective: The aim of this study was to determine the prevalence of hepatitis B virus (HBV) infection in a cohort of HIV-infected Rwandan children and adolescents on combination antiretroviral therapy (cART), and the success rate of HBV vaccination in those children found to be HBV negative. Methods: HIV-infected children and adolescents (age 8-17 years) receiving cART with CD4 T-cells count ≥200 cells/mm3 and/or ≥15% and without prior HBV vaccination (by history, vaccination cards and clinic records) underwent serologic testing for past (negative HBV surface antigen [HBsAg] with positive antibody to HBV core antigen [cAb] and to HBsAg [anti-HBs]) or active HBV infection (positive HBsAg). Children with any positive HBV serologic tests were excluded from further vaccination; all others completed 3 HBV immunizations with 10 μg of ENGERIX-B. Anti-HBs titer was measured 4-6 weeks after the last immunization. Results: Of 88 children, 6 (7%) children had active HBV infection and 8 (9%) had past HBV infection. The median (interquartile range) age, CD4 T-cell count and cART duration were 12.3 (10.1-13.9) years, 626 (503 to 942) cells/mm3 and 1.9 (1.5-2.7) years, respectively. Seventeen children had detectable plasma HIV-1 RNA. Seventy-3 children completed 3 immunizations with median (interquartile range) postimmunization anti-HBs concentration of 151 mlU/mL (1.03-650). Overall, 52 children (71%, 95% confidence interval: 61-82) developed a protective anti-HBs response. HIV-1 RNA and CD4 T-cell count were independent predictors of a protective anti-HBs response. Protective anti-HBs response was achieved in 82% of children with undetectable HIV-1 RNA and 77% with CD4 T cells >350/mm3. Conclusions: The substantial HBV prevalence in this cohort suggests that HIV-infected Rwandan children should be screened for HBV before cART initiation. HIV viral suppression and CD4 T cells ≥350/mm3 favored the likelihood of a protective response after HBV vaccination.

KW - Hepatitis B

KW - HIV-infected children and adolescents

KW - Rwanda

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U2 - 10.1097/INF.0b013e318271b93d

DO - 10.1097/INF.0b013e318271b93d

M3 - Article

C2 - 22976050

AN - SCOPUS:84876282101

SN - 0891-3668

VL - 32

SP - 246

EP - 251

JO - Pediatric Infectious Disease Journal

JF - Pediatric Infectious Disease Journal

IS - 3

ER -

Hepatitis B virus prevalence and vaccine response in HIV-infected children and adolescents on combination antiretroviral therapy in Kigali, Rwanda

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