scholarly journals Immune Response to Hepatitis B Virus Vaccine Among People Living With HIV: A Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Yakun Tian ◽  
Wei Hua ◽  
Yaxin Wu ◽  
Tong Zhang ◽  
Wen Wang ◽  
...  
Keyword(s):  
Response Rate ◽  
Standard Dose ◽  
Meta Analysis ◽  
Dose Schedule ◽  
People Living With Hiv ◽  
Double Dose ◽  
Hbv Vaccine ◽  
Hbv Vaccination ◽  
B Virus ◽  
Living With Hiv

BackgroundThere is conflicting evidence about whether a double dose of the hepatitis B virus (HBV) vaccine induces better immunity than the standard-dose vaccine for people living with HIV (PLWH). This study provides a meta-analysis that summarizes the efficacy of HBV vaccine regimens among HIV-infected patients, clarifying the role of particular factors such as dose and frequency of vaccination in vaccine responsiveness and highlighting the need for evidence-based practice to assess HBV vaccination among PLWH.MethodsRandomized clinical trials (RCTs) and prospective studies reporting vaccination response rates among PLWH were found through a search of PubMed, Cochrane, and the Web of Science. The key outcome was vaccine response. A random-effects model was used to estimate the pooled response rate. Subgroup analysis was conducted to evaluate key factors and explore sources of heterogeneity. Possible biases were assessed using quality and publication bias assessment.ResultsEligible studies included controlled trials that examined the effects of 17 interventional studies with 1,821 participants. Among PLWH who received the HBV vaccine, the pooled response rate of HBV vaccination was 71.5% (95% CI 64.0%–77.9%, p < 0.001). Compared with the standard dose (65.5%, 95% CI 53.1%–76.1%), the double dose (75.2%, 95% CI 66.2%–82.5%) was associated with a better response rate [Q(1) = 19.617, p < 0.001]. When stratified by schedule, the four-dose schedule (89.7%, 95% CI 83.1%–93.9%) had a higher response rate than the three-dose schedule (63.3%, 95% CI 56.6%–69.4%) and the difference was significant [Q(1) = 88.305, p < 0.001]. PLWH with higher CD4+ T-cell counts (>500 cells/mm3) at the time of vaccination had better response rates [Q(1) = 88.305, p < 0.001].ConclusionsIn this meta-analysis, the double dose of the HBV vaccine and multiple injections were associated with better immune responses than the standard HBV vaccine regimen in PLWH. Higher seroconversion rates were observed in PLWH with high CD4+ T-cell levels, indicating that individuals infected with HIV should receive the HBV vaccine as soon as possible after diagnosis.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/.

scholarly journals 1054. A Randomized Controlled Trial of Hepatitis B virus (HBV) Revaccination among Men Who Have Sex with Men and Were Born in the Era of Universal Neonatal HBV Immunization

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S556-S557
Author(s):  
Yi-Chia Huang ◽  
Hsin-Yun Sun ◽  
Yu-Chung Chuang ◽  
Sung-Hsi Huang ◽  
Wen-Chun Liu ◽  
...  
Keyword(s):  
Dose Group ◽  
Standard Dose ◽  
High Titer ◽  
Hiv Positive ◽  
Baseline Characteristic ◽  
Serological Response ◽  
Double Dose ◽  
Hbv Vaccine ◽  
Hbv Vaccination ◽  
Sex With Men

Abstract Background People who have lost anti-HBs antibody decades after neonatal vaccination but are at high risk of acquiring HBV are recommended to undergo HBV revaccination. The optimal revaccination strategy remains unknown, however. We aimed to compare the efficacy of revaccination with standard- (20-μg) vs double-dose (40-μg) of HBV vaccine among men who have sex with men (MSM). Methods MSM aged ≥ 20 years who had undergone HBV vaccination at birth and tested negative for HBsAg and anti-HBc with anti-HBs titer < 10 mIU/ml were randomized to receive standard- or double-dose HBV vaccine (1:1 ratio with a block size of 4) at weeks 0, 4, and 24. Plasma HIV RNA < 50 copies/ml for ≥ 6 months was required for HIV-positive MSM. The primary endpoint was the proportion of participants achieving anti-HBs ≥ 10 mIU/ml at week 28. The secondary endpoints were high-titer response (≥ 100 mIU/ml) at weeks 28 and 48, serological response at week 48, and adverse events (AE). Results From Sep 2017 to Jun 2020, 161 HIV-positive and 77 HIV-negative MSM were enrolled. The serological response at week 28 was 86.2% for the standard-dose group and 94.9% for the double-dose group (p=0.070). The proportion of high-titer response was higher for the double-dose group than the standard-dose group at 28 weeks (84.6% vs 70.1%, p=0.041). The respective serological response and high-titer response at week 48 were 81.3% and 58.7% for the standard-dose group vs 94.2% and 78.3% for the double-dose group (p=0.023 and p=0.013, respectively). In generalized estimating equations model, double-dose HBV revaccination (aOR, 1.7; 95% CI, 1.1-2.8) and baseline anti-HBs ≥ 2.5 mIU/ml (aOR, 7.5; 95% CI, 4.3-13.5) were associated with high-titer responses. HIV infection was not associated with serological response (aOR, -1.2; 95%CI, -2.47-1.60) and high-titer response (aOR, -1.1; 95%CI, -1.95-1.49). The double-dose group had a higher rate of local AEs (27.2% vs 38.7%, p=0.118). One (0.8%) severe AE occurred in the double-dose group, which resolved without sequelae. Table 1. Baseline characteristic of participants Table 2. Serological response after revaccination Table 3. GEE model of vaccine efficacy and associated factors Conclusion Double-dose HBV revaccination results in sustained serological and high-titer responses among MSM who were born in the era of universal neonatal HBV vaccination. Anti-HBs titer ≥ 2.5 mIU/ml at baseline is associated with high-titer response. Disclosures All Authors: No reported disclosures

scholarly journals 27. Hepatitis B Virus Screening and Vaccination in Patients with HIV: A Survey of Physicians’ Current Clinical Practices

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S37-S38
Author(s):  
Elizabeth Hastie ◽  
Darcy Wooten
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
People Living With Hiv ◽  
Virologic Suppression ◽  
High Morbidity ◽  
Clinical Practices ◽  
Hbv Vaccination ◽  
B Virus ◽  
Living With Hiv ◽  
The Impact

Abstract Background Hepatitis B virus (HBV) and HIV co-infection is associated with high morbidity and mortality, but data and guidelines vary in terms of the best vaccination, re-vaccination, and monitoring practices. The purpose of this study was to evaluate the current HBV monitoring and vaccination practices of physicians who care for patients living with HIV. Methods A Web-based survey was distributed to the University of California San Diego (UCSD) Infectious Diseases division via the UCSD ID listserv, Infectious Disease Society of America (IDSA) members via the IDea Exchange listserv, and to ID and HIV social network members via Twitter and Facebook. The survey consisted of demographic questions followed by two sets of case-based questions. The case questions focused on type, timing, and dosage of HBV vaccination administration among people living with HIV, HBV monitoring post-vaccination, and clinical approach to patients with isolated hepatitis B core antibody. Results A total of 67 clinicians from 24 states completed the survey (Table 1). Most (55%) provide care for more than 20 patients living with HIV per month. The majority of participants (82%) would not defer HBV vaccination until HIV virologic suppression. Almost half of participants (43%) indicated they would use Heplisav-B over older HBV vaccine formulations (Energix-B or Recombivax-HB) for initial vaccination of susceptible patients. The majority (88%) would repeat a vaccination series if the patient does not seroconvert; 23% would repeat with a standard dose series of Energix-B or Recombivax-HB, 24% with a double dose series of Energix-B or Recombivax-HB, and 45% would repeat with Heplisav-B. Approach to management of a patient living with HIV with isolated hepatitis B core antibody was varied. The majority would check a HBV DNA level (42%), while 25% would initiate a vaccination series and 24% would not pursue further intervention (Table 2). Table 1: Clinician Demographics Table 2: HBV Vaccination Practices of Physicians Caring for People Living with HIV Conclusion This study provides insight into current HBV vaccination and monitoring practices of physicians who care for patients with HIV. The results revealed varied practice preferences and opportunities for improvement through standardization. Additional research is needed to elucidate the impact these various practices have on patient outcomes and healthcare expenditure. Disclosures All Authors: No reported disclosures

scholarly journals Incidence of Herpes Zoster in HIV-Infected Patients Undergoing Antiretroviral Therapy: A Systematic Review and Meta-analysis

2021 ◽  
Vol 10 (11) ◽  
pp. 2300
Author(s):  
Han-Chang Ku ◽  
Yi-Tseng Tsai ◽  
Sriyani-Padmalatha Konara-Mudiyanselage ◽  
Yi-Lin Wu ◽  
Tsung Yu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Herpes Zoster ◽  
Antiretroviral Therapy ◽  
Random Effects ◽  
Meta Analysis ◽  
People Living With Hiv ◽  
Funnel Plots ◽  
Sex With Men ◽  
Treat All ◽  
Living With Hiv

The incidence of herpes zoster (HZ) in patients infected with HIV is higher than that of the general population. However, the incidence of HZ in HIV patients receiving antiretroviral therapy (ART) remains unclear. This meta-analysis aimed to estimate the pooled incidence rate and risk factors for HZ in the post-ART era. We identified studies assessing the incidence of HZ in the post-ART era between 1 January 2000 and 28 February 2021, from four databases. Pooled risk ratios were calculated from 11 articles using a random-effects model. The heterogeneity of the included trials was evaluated by visually inspecting funnel plots, performing random-effects meta-regression and using I2 statistics. Of the 2111 studies screened, we identified 11 studies that were eligible for final inclusion in the systematic review and 8 studies that were eligible for a meta-analysis. The pooled incidence of HZ in the post-ART era (after the introduction of ART in 1997) was 2.30 (95% confidence interval (CI): 1.56–3.05) per 100 person years (PYs). The risks of incidence of HZ among people living with HIV included male sex (AOR: 4.35 (95% CI: 054–2.41)), men who have sex with men (AOR: 1.21 (95% CI: −0.76–1.13)), CD4 count < 200 cells/μL (AOR: 11.59 (95% CI: 0.53–4.38)) and not receiving ART (AOR: 2.89 (95% CI: −0.44–2.56)). The incidence of HZ is substantially lower among HIV infected patients receiving ART than those not receiving ART. Initiating ART immediately after diagnosis to treat all HIV-positive individuals is crucial to minimize the disease burden of HZ.

PEOPLE LIVING WITH HIV, LEAN MASS, AND SARCOPENIA: A SYSTEMATIC REVIEW AND META-ANALYSIS

2021 ◽  
Author(s):  
Nathalia Sernizon Guimarães ◽  
Mariana Amaral Raposo ◽  
Dirceu Greco ◽  
Unaí Tupinambás ◽  
Melissa Orlandin Premaor
Keyword(s):  
Systematic Review ◽  
Lean Mass ◽  
Meta Analysis ◽  
People Living With Hiv ◽  
Living With Hiv

scholarly journals Rates and risk factors for suicidal ideation, suicide attempts and suicide deaths in persons with HIV: a systematic review and meta-analysis

2021 ◽  
Vol 34 (2) ◽  
pp. e100247
Author(s):  
Matt Pelton ◽  
Matt Ciarletta ◽  
Holly Wisnousky ◽  
Nicholas Lazzara ◽  
Monica Manglani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Suicidal Ideation ◽  
General Population ◽  
Suicide Attempts ◽  
Advanced Disease ◽  
Meta Analysis ◽  
People Living With Hiv ◽  
Meta Regression ◽  
Living With Hiv

BackgroundPeople living with HIV/AIDS (PLWHA) must contend with a significant burden of disease. However, current studies of this demographic have yielded wide variations in the incidence of suicidality (defined as suicidal ideation, suicide attempt and suicide deaths).AimsThis systematic review and meta-analysis aimed to assess the lifetime incidence and prevalence of suicidality in PLWHA.MethodsPublications were identified from PubMed (MEDLINE), SCOPUS, OVID (MEDLINE), Joanna Briggs Institute EBP and Cochrane Library databases (from inception to before 1 February 2020). The search strategy included a combination of Medical Subject Headings associated with suicide and HIV. Researchers independently screened records, extracted outcome measures and assessed study quality. Data were pooled using a random-effects model. Subgroup and meta-regression analyses were conducted to explore the associated risk factors and to identify the sources of heterogeneity. Main outcomes were lifetime incidence of suicide completion and lifetime incidence and prevalence of suicidal ideation and suicide attempt.ResultsA total of 185 199 PLWHA were identified from 40 studies (12 cohorts, 27 cross-sectional and 1 nested case-control). The overall incidence of suicide completion in PLWHA was 10.2/1000 persons (95%CI: 4.5 to 23.1), translating to 100-fold higher suicide deaths than the global general population rate of 0.11/1000 persons. The lifetime prevalence of suicide attempts was 158.3/1000 persons (95%CI: 106.9 to 228.2) and of suicidal ideation was 228.3/1000 persons (95%CI: 150.8 to 330.1). Meta-regression revealed that for every 10-percentage point increase in the proportion of people living with HIV with advanced disease (AIDS), the risk of suicide completion increased by 34 per 1000 persons. The quality of evidence by Grading of Recommendations, Assessment, Development and Evaluations for the suicide deaths was graded as ‘moderate’ quality.ConclusionsThe risk of suicide death is 100-fold higher in people living with HIV than in the general population. Lifetime incidence of suicidal ideation and attempts are substantially high. Suicide risk assessments should be a priority in PLWHA, especially for those with more advanced disease.

scholarly journals Adherence to Highly Active Antiretroviral Therapy and Its Association with Serostatus Disclosure among People Living with HIV in Ethiopia:  A Systematic Review and Meta-Analysis.

2020 ◽  
Author(s):  
Abere Woretaw Azagew ◽  
Chilot Kassa Mekonnen ◽  
Abebaw Jember Ferede ◽  
Kassahun Gebeyehu Yazew ◽  
Zewdu Baye Tezera
Keyword(s):  
Systematic Review ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Assessment Tool ◽  
Meta Analysis ◽  
People Living With Hiv ◽  
Serostatus Disclosure ◽  
Highly Active ◽  
Pooled Prevalence ◽  
Living With Hiv

Abstract Background: Adherence to highly active antiretroviral therapy (HAART) is a public health challenge worldwide. Non-adherence to HAART leads to treatment, immunologic, and virological failure. Despite different interventions made, adherence to HAART among adult people living with HIV (PLWHIV) is still inconsistent across studies, and the effect of serostatus disclosure on adherence to HAART was not studied in Ethiopia. Therefore, the study is aimed to determine the pooled prevalence of adherence to HAART and its relationship with serostatus disclosure among adult PLWHIV in Ethiopia.Methods: We searched 3247 original articles, both published and unpublished on Ethiopia dated from January 2016 to November 2019 by using different search engines. Data were extracted using Microsoft excel. New Castle Ottawa Scale quality assessment tool was used. STATA software version 11 was used for analysis. A random-effects model for meta-analysis was computed. Cochran Q statistics and I2 were used to estimate heterogeneity. Egger’s and Begg’s test was used to assess the publication bias.Results: A total of fifteen articles for systematic review and four articles for meta-analysis were used. The pooled prevalence of adherence to HAART is found to be 81.19% (80.1, 82.3). In the subgroup analysis, the pooled prevalence of adherence to HAART was 79.82% (73.19, 86.45) in the Oromia region, 82.51 %( 73.14, 91.87) in the Amhara region, and 72.7% (63.78, 81.61) in the Southern Nations Nationalities and Peoples’ Region (SNNPR). The serostatus disclosure improves adherence to HAART by nearly three times compared to non-serostatus disclosed PLWHIV (AOR=2.99, 95 %CI: 1.88, 4.77).Conclusions: The pooled prevalence of adherence to HAART among adult PLWHIV in Ethiopia was found to be low compared to WHO antiretroviral treatment recommendations. Having serostatus disclosure improved adherence to HAART.

scholarly journals Influence of Material Deprivation on Clinical Outcomes Among People Living with HIV in High-Income Countries: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Vasiliki Papageorgiou ◽  
Bethan Davies ◽  
Emily Cooper ◽  
Ariana Singer ◽  
Helen Ward
Keyword(s):  
Systematic Review ◽  
Social Determinants ◽  
Meta Analysis ◽  
Hiv Treatment ◽  
Material Deprivation ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Hiv Care Continuum ◽  
Care Continuum ◽  
Living With Hiv

AbstractDespite developments in HIV treatment and care, disparities persist with some not fully benefiting from improvements in the HIV care continuum. We conducted a systematic review to explore associations between social determinants and HIV treatment outcomes (viral suppression and treatment adherence) in high-income countries. A random effects meta-analysis was performed where there were consistent measurements of exposures. We identified 83 observational studies eligible for inclusion. Social determinants linked to material deprivation were identified as education, employment, food security, housing, income, poverty/deprivation, socioeconomic status/position, and social class; however, their measurement and definition varied across studies. Our review suggests a social gradient of health persists in the HIV care continuum; people living with HIV who reported material deprivation were less likely to be virologically suppressed or adherent to antiretrovirals. Future research should use an ecosocial approach to explore these interactions across the lifecourse to help propose a causal pathway.

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