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Modified Dose and Schedule of Recombinant Hepatitis B Vaccination in HIV-infected Adult Subjects

Phase 3
Conditions
HIV Infection
Interventions
Biological: Hepavax-Gene
Registration Number
NCT01289106
Lead Sponsor
Chiang Mai University
Brief Summary

The purposes of this study include 1) to compare the seroconversion rate of an intensive standard-dose regimen (0, 1, 2 and 6 months) to a standard-dose regimen (0,1 and 6 months), and 2) to compare the seroconversion rate of an intensive double-dose regimen (40 μg at 0,1,2 and 6 months) to a standard-dose regimen (20 μg at 0,1 and 6 months) of HBV vaccine in HIV-infected adult patients.

Detailed Description

HIV and HBV share similar risk factors and routes of transmission. HIV/HBV coinfection is associated with greater chance of chronic HBV carrier state, higher level of HBV replication and increasing its potential for transmission. Currently, there are no concrete data to determine the best HBV vaccination schedule in HIV-infected patients. Standard HBV vaccination (20 μg at 0, 1 and 6 months) gives seroconversion rate of 33-63% in HIV-infected individuals compared with \>90% in healthy individuals. This study aims to compare the efficacy of an intensive standard-dose regimen (0, 1, 2 and 6 months) to a standard-dose regimen (0,1 and 6 months) and to compare the seroconversion rate of an intensive double-dose regimen (40 μg at 0,1,2 and 6 months) to a standard-dose regimen (20 μg at 0,1 and 6 months) of HBV vaccine in HIV-infected adult patients with CD4 level above 200 permm3 and suppressed viral load.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
132
Inclusion Criteria
  • Positive for anti-HIV antibody
  • At least 18 years of age
  • CD4 > 200 cell/mm3
  • On antiretroviral therapy
  • Viral load < 50 copies/ml
  • Negative for any HBV serological marker (HBsAg, Anti-HBs, Anti-HBc)
  • No history of previous hepatitis B vaccination
  • Anti-HCV negative
  • No active opportunistic infection at the time of screening
  • Willing to sign informed consent
  • Able to follow up
Exclusion Criteria
  • Pregnancy or breast feeding
  • History of hypersensitivity to any component of vaccine
  • Diagnosis of malignancy and receiving chemotherapy or radiation
  • Other immunocompromised conditions not related to HIV infection (solid-organ transplantation, chemotherapy in the last 6 months)
  • On Immunosuppressive treatment, immunomodulating treatment or corticosteroid (equal or above 0.5 mg per kg per day of prednisolone)
  • Renal failure (creatinine clearance < 30 mL/min)
  • Decompensated cirrhosis (child-pugh C)
  • Not able to follow up

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm AHepavax-Gene20 μg of Hepavax-gene intramuscularly injections at deltoid region at 0,1 and 6 months
Arm BHepavax-Gene20 μg of Hepavax-gene intramuscularly injections at deltoid region at 0,1,2 and 6 months
Arm CHepavax-Gene40 μg of Hepavax-gene intramuscularly injections at deltoid region at 0,1,2 and 6 months
Primary Outcome Measures
NameTimeMethod
Seroconversion rate (percentage of subjects with anti-HBs antibody titer >= 10 IU/L) at day 210Day 210

1. To compare the seroconversion rate at day 210 of an intensive standard-dose regimen (0, 1, 2 and 6 months) to a standard-dose regimen (0,1 and 6 months)

2. To compare the seroconversion rate at day 210 of an intensive double-dose regimen (40 μg at 0,1,2 and 6 months) to a standard-dose regimen (20 μg at 0,1 and 6 months) of HBV vaccine in HIV-infected adult patients

Secondary Outcome Measures
NameTimeMethod
Seroprotective rate (percentage of subjects with anti-HBs antibody titer >= 10 IU/L) at 1 year1 year

To determine the seroprotective rate at 1 year of each of the vaccination regimens.

Number of subjects with adverse events after vaccination180 days

Adverse events include pain at injected site, swelling at injected site, redness at injected site, fever, headache, fatique and anaphylaxis

Trial Locations

Locations (1)

Maharaj Nakorn Chiang Mai Hospital, Department of Medicine, Chiang Mai University

🇹🇭

Muang, Chiang Mai, Thailand

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