GM-CSF Fails to Improve Immune Responses to Booster Hepatitis B Vaccination in HIV-Infected Individuals

Edgar T Overton*, 1, Somnuek Sungkanuparph2, Michael Klebert1, Michael Royal1, Debra Demarco-Shaw1, William G Powderly3, Judith A Aberg4
1 Washington University, St Louis, MO, USA
2 Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
3 School of Medicine and Medicine Sciences, University College Dublin, Dublin, Ireland
4 New York University, New York, NY, USA

© Overton et al.; Licensee Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Division of Infectious Diseases, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8011, St Louis, MO 63110, USA; Tel: (314) 454-8225; Fax: (314) 454-5392; E-mail:



Hepatitis B (HBV) vaccination is an important preventive intervention for HIV-infected population. Data regarding booster HBV vaccine for persons with low HBV surface antibody (sAb) titers after vaccination in this immunocompromised population is lacking.


We randomized 60 HIV-infected subjects lacking HBV protection after completion of 3 doses of HBV vaccine to receive a booster dose of HBV vaccine with 250mcg GM-CSF as an adjuvant or booster vaccine alone.


GM-CSF was safe with expected side effects. However, only 35% of persons receiving GM-CSF developed protective sAb while 50% in vaccine only arm developed protection (P = 0.47). Overall, only 28% of subjects maintained protective sAb 1 year after vaccination.


GM-CSF failed to improve responses to the booster HBV vaccination. Overall, response was poor with only 42% of persons responding at one month post-vaccination confirming booster vaccination with the current HBV vaccine has poor immunogenicity among HIV-infected persons. Further research is needed to develop optimal vaccination strategies in HIV-infected persons.

Keywords: HIV, HBV vaccination, GM-CSF, adjuvant..