Does increased hepatitis B vaccination dose lead to a better immune response in HIV-infected patients than standard dose vaccination: a meta-analysis?

Human immunodeficiency virus (HIV)-infected patients often fail to produce protective antibodies to hepatitis B virus (HBV) vaccine. Some reports have suggested that increased-dose vaccination improves immune response to HBV vaccine in HIV-infected patients. To assess the efficacy of increased-dose HBV vaccination in HIV-infected patients, a systematic review of the literature and meta-analysis of clinical trials was conducted. We only included trials that compared the response rate at completion of HBV vaccine schedules in patients who had increased-dose HBV vaccine courses with controls (standard-dose HBV vaccine vaccination schedule). The fixed-effects model, with heterogeneity and sensitivity analyses, was used in this study. We identified five studies involving 883 HIV-positive vaccine recipients. Pooling of study results showed a significant increase in response rates among high-dose patients versus control patients; the pooled odds ratio (OR) was 1.96 (95% confidence interval [CI]: 1.47; 2.61). Four out of five identified studies included only vaccine-naive patients. The overall OR was 1.82 (95% CI: 1.35-2.47). No study heterogeneity was found. Our meta-analysis showed that increasing the dosage of vaccine may significantly improve immune responses in HIV-infected patients.

[Experimental study of bovine bone morphogenetic protein combined with sintered bone in the treatment of bone defects].

OBJECTIVE: To confirm the capability of ectopic bone induction of the bovine bone morphogenetic protein (bBMP), and investigate the bBMP combined with sintered bone (SB) in the treatment of bone defects. METHODS: bBMP was separated from the bovine cortical bone and implanted into the muscle pouches of the balb/c mouses. 4 mouses were killed at the 1st, 2nd, 3rd and 4th week, and their tissues were fixed in 4% formalin for histologic examination. The bBMP was combined with sintered bovine cancellons bone (SB), and segmental defects were made at raddi in 16 New Zealand rabbits. One side of the rabbits was implanted with bBMP-SB, and another side implanted with SB. The animals were killed in the 2nd, 4th, 6th and 8th week after operation for X-ray and histologic examination. RESULTS: One week after bBMP implantation, the chondrocyte was induced in muscle pouches, the woven bone was seen in 2 weeks, and the trabecular bone was formed in 4 weeks. In bone defects models, the X-ray and histologic examination showed that all parameters (chondrocyte induction, the mount of the trabecular bone, defects heal) were better in the animals treated with bBMP-SB than that with SB. CONCLUSION: 1. bBMP can induce ectopic bone formation. 2. bBMP-SB can improve the healing of the bone defects.