PROTECTIVE IMMUNITY TO HBV IN HIV+ PATIENTS WITH ISOLATED HEPATITIS B

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 乙肝病毒(乙肝病毒)仍然是全球最常见的传染病之一，仅次于艾滋病毒，成为第十大死因。乙肝病毒感染的血清学模式、定义和结果极其复杂，导致了差异很大的乙肝疫苗接种和治疗建议。有过乙肝病毒感染史的一个标志是抗乙肝核心抗原抗体(抗-HBc)。然而，某些患者有“孤立的抗-HBc”，没有任何其他乙肝病毒的血清学证据，因此没有明确的证据表明有针对乙肝病毒表面抗原(抗-HBs)的抗体具有保护性免疫。艾滋病病毒感染者(13-40%)、丙型肝炎病毒感染者(20-30%)和艾滋病毒/丙型肝炎病毒携带者(高达80%)中，单独的抗-HBc感染率很高。研究表明，部分单独的抗-HBc携带者是乙肝病毒携带者，可检测到的病毒血症或HBVDNA约为10%-30%。我们的目标是确定那些单独抗-HBc和没有检测到HBVDNA的人对疫苗接种的反应。我们将使用单次疫苗接种后的抗体滴度作为既往感染(高滴度，或记忆反应)或未感染(低滴度，或主要反应)的指示。鉴于疫情的流行，我们有必要确定一种单独的抗-HBc的免疫学意义，特别是在高危人群中，如艾滋病毒和丙型肝炎患者。 假设：单独抗-HBc抗体的HIV阳性患者对HBV有不同的免疫反应，其中一些具有保护性抗体，而另一些是易感的，将从全系列疫苗接种中受益。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Hepatitis B Virus (HBV) remains one of the most common infectious diseases worldwide, ranking behind HIV as the 10th leading cause of death. The serologic pattern, definitions and outcomes of HBV infection are extremely complicated, resulting in widely variable HBV vaccination and treatment recommendations. One marker of prior HBV infection is the antibody to hepatitis B core antigen (anti-HBc). However, certain patients have an "isolated anti-HBc" without any other serologic evidence of HBV, and thus no clear evidence of protective immunity with antibodies to HBV surface antigen (anti-HBs). A high prevalence of isolated anti-HBc has been reported in those with HIV (13-40%), HCV (20 -30%) and HIV/HCV (up to 80%). Studies have shown a proportion of individuals with isolated anti-HBc are carriers of HBV, with detectable viremia or HBV DNA in approximately 10-30%. Our objective is to determine the response to vaccination in those with isolated anti-HBc and without detectable HBV DNA. We will use the antibody titer in response to a single vaccination as indicative of prior infection (high titer, or anamnestic response) or no prior infection (low titer, or primary response). Given the epidemic it is essential that we ascertain the immunologic significance of an isolated anti-HBc, especially in high-risk groups, such as HIV and HCV patients. Hypothesis: HIV-positive patients with isolated Anti-HBc antibody have a variable immunologic response against HBV such that some have protective antibodies, whereas others are susceptible and will benefit from a full series of vaccination.