PROTECTIVE IMMUNITY TO HBV IN HIV+ PATIENTS WITH ISOLATED HBV CORE ANTIBODY

这个子项目是许多利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 B型肝炎病毒（HBV）仍然是世界范围内最常见的传染病之一，排在艾滋病毒之后，成为第10大死亡原因。 HBV感染的血清学模式、定义和结果极其复杂，导致HBV疫苗接种和治疗建议差异很大。 既往HBV感染的一个标志物是针对B型肝炎核心抗原的抗体（抗-HBc）。 然而，某些患者具有“分离的抗-HBc”，而没有任何其他HBV血清学证据，因此没有明确的证据表明对HBV表面抗原（抗-HBs）的抗体具有保护性免疫。 据报道，在HIV（13-40%）、HCV（20 - 30%）和HIV/HCV（高达80%）患者中，分离的抗HBc的患病率较高。 研究表明，一部分具有分离的抗-HBc的个体是HBV携带者，约10- 30%具有可检测的病毒血症或HBV DNA。 我们的目的是确定那些有分离的抗-HBc和没有检测到HBV DNA的人对疫苗接种的反应。 我们将使用对单次接种的抗体滴度作为既往感染（高滴度或回忆应答）或无既往感染（低滴度或初次应答）的指示。 鉴于流行病，我们必须确定分离的抗HBc的免疫学意义，特别是在高危人群中，如HIV和HCV患者。

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.