Document 0608
 DOCN  M95A0608
 TI    Antibody response to booster doses of hepatitis B vaccine in
       HIV-infected children. American Pediatric Society 104th annual meeting
       and Society for Pediatric Research 63rd annual meeting; 1994 May 2-5;
       Seattle.
 DT    9510
 AU    Choudhury SA; Hodes DS; Peters VB; Department of Pediatrics, Mount Sinai
       School of Medicine, N.Y.,; N.Y., USA.
 SO    Pediatr AIDS HIV Infect. 1994 Oct;5(5):321 (unnumbered abstract). Unique
       Identifier : AIDSLINE AIDS/95330436
 AB    We previously showed that the antibody response to Hepatitis B vaccine
       is poor in HIV-infected children (Pediatr Infect Dis J 1993; 12:877-8).
       In order to assess the utility of a booster dose, we administered
       Engerix at double the AAR-recommended dose to 14 symptomatic
       HIV-infected children (mean age 58 months, mean CD4 cell count 457/mm3)
       who had failed to respond to the AAP-recommended vaccine series.
       Anti-HBs antibody was assessed by ELISA 1-5 months (mean 2 months) after
       the booster. Of these children, 11 had no detectable response to the
       booster and 3 responded with a mean antibody titer of 59 SRU (53-65).
       Levels of anti-HBs of > or = 15 SRU are considered protective. The 3
       responders tended to be younger (mean age 35 months vs 65 months, p =
       0.06) and have higher CD4 cell counts (1100 vs 282/mm3, p = 0.06) than
       nonresponders. 7 of the 11 nonresponders received a 2nd booster. None
       developed protective antibody levels 2-7 months (mean 4 months) after
       the 2nd booster. In addition, we assessed the duration of protective
       antibody levels 7-13 months (mean 10 months) after completion of the
       vaccine series in 6 children who had originally responded to the
       AAP-recommended HBV vaccine series. 2 of these had lost detectable
       antibody. Hepatitis B vaccination in symptomatic HIV-infected children
       remains problematic.
 DE    Child  Child, Preschool  CD4 Lymphocyte Count  Enzyme-Linked
       Immunosorbent Assay  Hepatitis B Antibodies/*BIOSYNTHESIS  Hepatitis B
       Vaccines/ADMINISTRATION & DOSAGE/*IMMUNOLOGY  Human  HIV
       Infections/*IMMUNOLOGY  *Immunization, Secondary  Vaccines,
       Synthetic/ADMINISTRATION & DOSAGE/*IMMUNOLOGY  MEETING ABSTRACT  JOURNAL
       ARTICLE

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