DIMINISHED RESPONSE TO RECOMBINANT HEPATITIS-B VACCINE IN HOMOSEXUAL MEN WITH HIV ANTIBODY - AN INDICATOR OF POOR PROGNOSIS

Three doses of a recombinant DNA HBV vaccine (MSD) were given to healthy male homosexuals. Seventy‐eight out of 104 (77.6%) participants had detectable antibody (anti‐HBs) two months after the third dose. Seroconversion occurred in only 9 out of 27 subjects (33.3%) who were anti‐HIV positive compared with 69 out of 77 (89.6%) who were negative (χ2 = 30.8; P < .001). Fifteen of the 18 anti‐HIV positive who did not mount an antibody response to the hepatitis B vaccine (anti‐HBs) later progressed to persistent generalised lymphadenopathy syndrome (5), AIDS‐related complex (5), and AIDS (5). Only one of the nine anti‐HIV positive anti‐HBs responders developed PGL (χ2 = 10.14; P < .005). Our results show that anti‐HIV positive homosexuals are poor responders to the recombinant hepatitis B vaccine and anti‐HIV positive non‐responders are more likely to develop clinically apparent HIV infection. Copyright © 1990 Wiley‐Liss, Inc., A Wiley Company