ﻓﺼﻠﻨﺎﻣﻪ ﺗﻨﺪرﺳﺘﻲ و داﻧﺶ، دوره5 ﺷﻤﺎره، 1 ، ﺑﻬﺎر1389 داﻧﺸﮕﺎه ﭘﺰﺷﻜ ﻋﻠﻮم ﺷﺎﻫﺮود درﻣﺎﻧﻲ ﺑﻬﺪاﺷﺘﻲ ﺧﺪﻣﺎت و ﻲ * ﻧﻮﻳﺴﻨﺪه ﻣﺴ ﻮ ول: ﺗﻬﺮان ﭘﺰﺷﻜﻲ ﻋﻠﻮم داﻧﺸﮕﺎه- ﺧﻤﻴﻨﻲ اﻣﺎم ﺑﻴﻤﺎرﺳﺘﺎن- ﻋﻔﻮﻧﻲ ﮔﺮوه، ﺗﻠﻔﻦ: 66947984 - 021 ، Email: dr_emadi@yahoo.com ﭘﮋوﻫﺸﻲ ﻣﻘﺎﻟﻪ ﺑﺮرﺳﻲ ﻣﻴﺰان ﭘﺎﺳﺦ اﻳﻤﻨﻲ ﺳﻴﺴﺘﻢ ﺑﻴﻤﺎرانHIV/AIDS ﺑﻪ واﻛﺴﻴﻨﺎﺳﻴﻮن ﻫﭙﺎﺗﻴﺖB ﻧﮕﻴﻦ اﺳﻤﺎﻋﻴﻠﻲ ﭘﻮر 1 ) M.D. ( ، ﻧﺎﻫﻴﺪ ﻣﻴﺮزاﻳﻲ 2 ) M.D. ( ، ﭼﻤﻦ رﺿﺎ 3 (Ph.D.) ﻣﻬﺮﻧﺎز، رﺳﻮﻟﻲ ﻧﮋاد 4 ) M.D. ( ، ﻣﺤﺒﻮﺑﻪ ﺣﺎﺟﻲ ﻋﺒﺪاﻟﺒﺎﻗﻲ 4 ) M.D. ( ، ﻣﺮﻳﻢ رﻫﺎم 2 ) M.D. ( ، ﻧﻘﻲ ﻋﻠﻲ ﺳﻴﺪ اﺣﻤﺪ ﺳﻴﺪ) M.D ( 5 ، ﺣﺴﻴﻨﻲ ﺳﻴﺪﻣﺼﻄﻔﻲ 6 (Ph.D.) ، ﻣﺎزﻳﺎر ﭘﺎرﺳﺎ 1 ) M.D. ( ، ﻻدن ﭘﺎﻳﻮرﻣﻬﺮ 7 ) M.Sc. ( ﺣﻤﻴﺪ، ﻋﻤﺎدي ﻛﻮﭼﻚ * 1 ) M.D. ( 1 - ﻋﻠﻮم داﻧﺸﮕﺎه ﭘﺰﺷﻜﻲ ﺗﻬﺮان- ﻣﺮﻛﺰ ﺗﺤﻘﻴﻘﺎت اﻳﺪز اﻳﺮان- ﺑﻴﻤﺎري اﺳﺘﺎدﻳﺎر ﻋﻔﻮﻧﻲ ﻫﺎي. 2 - داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﻜﻲ ﺗﻬﺮان- ﺑﻴﻤﺎرﺳﺘﺎن اﻣﺎم ﺧﻤﻴﻨﻲ- ﮔﺮوه ﻋﻔﻮﻧﻲ- ﺑﻴﻤﺎري ﻣﺘﺨﺼﺺ ﻋﻔﻮﻧﻲ ﻫﺎي. 3 - ﻋﻠﻮم داﻧﺸﮕﺎه ﺷﺎﻫﺮود ﭘﺰﺷﻜﻲ- ﺳﻼﻣﺖ در اﺟﺘﻤﺎﻋﻲ و رﻓﺘﺎري ﻋﻠﻮم ﺗﺤﻘﻴﻘﺎت ﻣﺮﻛﺰ- اﭘﻴﺪﻣﻴﻮﻟﻮژي اﺳﺘﺎدﻳﺎر. 4 - ﻋﻠﻮم داﻧﺸﮕﺎه ﭘﺰﺷﻜﻲ ﺗﻬﺮان- ﻣﺮﻛﺰ ﺗﺤﻘﻴﻘﺎت اﻳﺪز اﻳﺮان- ﺑﻴﻤﺎري اﺳﺘﺎد ﻋﻔﻮﻧﻲ ﻫﺎي. 5 - ﻋﻠﻮم داﻧﺸﮕﺎه ﭘﺰﺷﻜﻲ ﺗﻬﺮان- ﻣﺮﻛﺰ ﺗﺤﻘﻴﻘﺎت اﻳﺪز اﻳﺮان- ﻋﻤﻮﻣﻲ ﭘﺰﺷﻚ6 - ﺗﻬﺮان ﭘﺰﺷﻜﻲ ﻋﻠﻮم داﻧﺸﮕﺎه- ﺑﻬﺪاﺷﺖ داﻧﺸﻜﺪه- اﭘﻴﺪﻣﻴﻮﻟﻮژي و آﻣﺎر ﮔﺮوه- داﻧﺸﻴﺎر. 7 - ﻋﻠﻮم داﻧﺸﮕﺎه ﭘﺰﺷﻜﻲ ﺗﻬﺮان- ﻣﺮﻛﺰ ﺗﺤﻘﻴﻘﺎت اﻳﺪز اﻳﺮان- ﭘﺮﺳﺘﺎري ارﺷﺪ ﻛﺎرﺷﻨﺎس. درﻳﺎﻓﺖ ﺗﺎرﻳﺦ: 23 / 12 / 1388 ، ﭘﺬﻳﺮش ﺗﺎرﻳﺦ: 20 / 5 / 1389 ﭼﻜﻴﺪه ﻣﻘﺪﻣﻪ: ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ اﺣﺘﻤﺎل ﺑﺎﻻﺗﺮ ازﻣﺎن ﻋﻔﻮﻧﺖ ﻫﭙﺎﺗﻴﺖB در ﻋﻔﻮﻧﺖ داراي اﻓﺮادHIV ، اﻳﻤﻦ ﺳﺎزي ﺑﺮ ﻋﻠﻴﻪ ﻫﭙﺎﺗﻴﺖB در اﻳﻦ ﺑﻴﻤﺎران ﺿﺮورت دارد. ﻫﺪف از اﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺮرﺳﻲ ﻋﻮاﻣﻞ ﻣﺆﺛﺮ ﺑﺮ ﭘﺎﺳﺦ ﻳ ﺎ ﻋﺪم ﭘﺎﺳﺦ ﺑﻪ واﻛﺴﻴﻨﺎﺳﻴﻮن ﻫﭙﺎﺗﻴﺖB ﻣﻮارد در اﻳﺮاﻧﻲHIV + در ﻣﻘﺎﻳﺴﻪ ﺑﺎ ﮔﺮوه ﺷﺎﻫﺪ ﺳﺎﻟﻢ ﺑﻮده اﺳﺖ. روش و ﻣﻮاد ﻫﺎ: از اردﻳﺒﻬﺸﺖ ﻣﺎه86 ﺗﺎ ﺧﺮداد ﻣﺎه87 , 50 ﻣﻮردHIV + و50 ﻧﻔﺮ اﻓﺮاد ﮔﺮوه ﺷﺎﻫﺪ ﺳﺎﻟﻢ ﻛﻪ از ﻧﻈﺮ ﺷﻮاﻫﺪ ﺳﺮوﻟﻮژﻳﻚ ﻫﭙﺎﺗﻴﺖB ﻣﻨﻔﻲ ﺑﻮدﻧﺪ، ﺗﺤﺖ واﻛﺴﻴﻨﺎﺳﻴﻮن ﻫﭙﺎﺗﻴﺖ B در ﺳﻪ دز ﻣﺮاﺟﻌﻪ اوﻟﻴﻦ، 1 و6 ﻣﺎه ﺑﻌﺪ ﻗﺮار ﮔﺮﻓﺘﻨﺪ و2 - 1 ﻣﺎه ﺑﻌﺪ از ﺗﺰرﻳﻖ آﺧﺮﻳﻦ دز واﻛﺴﻦ ﺗﻴﺘﺮاژ ﺗﻌﻴﻴﻦ ﺑﻪ ﻧﺴﺒﺖHBS Ab آن اﻗﺪام ﻫﺎ و ﻣﻴﺰان ﭘﺎﺳﺦ ﺑﻪ واﻛﺴﻦ ﺑﺮ اﺳﺎس ﺗﻴﺘﺮHBS Ab ﺑﺮرﺳﻲ ﮔﺮدﻳﺪ. ﻧﺘﺎﻳﺞ: در ﮔﺮوهHIV + ﺗﻌﺪاد40 ﻧﻔﺮ) 80 (% در و ﮔﺮوه ﺷﺎﻫﺪ46 ﻧﻔﺮ) 92 (% ﺑﻪ واﻛﺴﻦ ﭘﺎﺳﺦ وﻟﻲ دادﻧﺪ اﺧﺘﻼف ﺑﻴﻦ دو آﻣﺎري ﻧﻈﺮ از ﮔﺮوه ﻣﻌﻨﺎدار ﻧﺒﻮد) 8 / 0 = P ( . در ﮔﺮوهHIV + ﭘﺎﺳﺦ ﺑﻪ واﻛﺴﻦ ﺑﺎ ﺳﻦ، ﺟﻨﺲ،BMI ) ﺑﺪﻧﻲ ﺗﻮده ﺷﺎﺧﺺ( ، ﻣﺼﺮف ﺳﻴﮕﺎر، ﻣﺼﺮف اﻟﻜﻞ، راه اﺑﺘﻼ، ﻣﺮﺣﻠﻪ و ﺑﻴﻤﺎري درﻣﺎن اﻳﺪز ﻋﺎﻣﻞ وﻳﺮوس ﺿﺪ ارﺗﺒﺎط ﻧﺪاﺷﺖ. ﻣﻴﺰان ﭘﺎﺳﺦ در ﮔﺮوهHIV + ، ارﺗﺒﺎط ﻣﻌﻨﺎداري ﺑﺎ ﺳﻄﺢCD4 ﺑﻴﻤﺎران داﺷﺖ) 03 / 0 = P ( . ﻧﺘﻴﺠﻪ ﮔﻴﺮي: واﻛﺴﻴﻨﺎﺳﻴﻮن ﻫﭙﺎﺗﻴﺖB در ﺑﻴﻤﺎرانHIV + ﺑﻬﺘﺮ اﺳﺖ در اواﻳﻞ ﺑﻴﻤﺎري و ﺑﺎ ﻫﻤﺎن د ز ﻣﻌﻤﻮل ﺻﻮرت ﮔﻴﺮد و در ﺑﻴﻤﺎران ﺑﺎCD4<200 cell/μl ﺗ ﻴﺘﺮHBS Ab در ﻓﻮاﺻﻞ ﻣﻌﻴﻦ اﻧﺪازه ﮔﻴﺮي ﺷﻮد. واژه ﻫﺎي ﻛﻠﻴﺪي: واﻛﺴﻴﻨﺎﺳﻴﻮن، ﻫﭙﺎﺗﻴﺖB ، اﻳﺪز اﻧﺴﺎﻧﻲ، اﻳﻤﻨﻲ ﻧﻘﺺ وﻳﺮوس. Original Article Knowledge & Health 2010; 5(1):1-4 Investigating HIV/AIDS Patients’ Immune Response to Hepatitis B Vaccination Negin Esmaeilpour 1 , Nahid Mirzaei 2 , Reza Chaman 3 , Mehrnaz Rasoulinejad 4 , Mahboobeh Haji-Abdolbaghi 4 , Maryam Roham 2 , SeyedAhmad SeyedAlinaghi 5 , Seyyed Mostafa Hosseini 6 , Mazeyar Parsa 1 , Ladan Payvar- Mehr 7 , Hamid Emadi-Koochak 1* 1- Assistant Professor, Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Tehran, Iran. . 2- MD, Infectious Diseases Department, Imam Khomeini Hospital, Tehran, Iran. 3-Assistant Professor of Epidemiology, Center for Health related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran. 4- Professor, Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Tehran, Iran. 5-General Practitioner, Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Tehran, Iran 6- Associate Professor of Biostatistics, Tehran University of Medical Sciences, Tehran, Iran. 7- M.Sc. of Nursing, Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Tehran, Iran. Abstract: Introduction: Because of the increased risk of chronicity of hepatitis B in HIV infected patients, immunization against HBV is recommended in patients infected with human immune deficiency virus. This study aims at determining the factors which affect the response to HBV vaccination in Iranian HIV positive adults, compared with a healthy control group. Methods: From April 2007 to May 2008, 50 HIV + and 50 healthy control subjects who were seronegative for HBV received 3 doses of hepatitis B vaccine at 0, 1 and 3-month points. About 1-2 months after the last dose of vaccine, HBS antibodies were tested in the two groups. Persons were considered vaccine responders if their HBS antibody levels were greater than 10 mIU/ml. Results: In the HIV + group 40 cases (80%) were vaccine responder and in control group, 46(92%) people responded to vaccine .The difference between the two groups was not statistically significant (P=0.8). There were no significant relationships between age, gender, BMI, smoking, alcohol drinking and the method infection and HARRT treatment. In the HIV group vaccine response was associated with CD4 count level (P=0.03). Conclusion: HIV infected patients are recommended to be HBV vaccinated at the regular doses and intervals. If CD4 count is less than 200/μl, HBS antibody should be tested in certain period for HIV+ individuals. Keywords: Vaccination, Hepatitis B, HIV/AIDs. Received:14 March 2010 Accepted: 11 August 2010 *Corresponding author: H. Emadi-Koochak, Email: dr_emadi@yahoo.com