To the Editor: In their study on safety and immunogenicity of different hepatitis B vaccine regimens in adults infected with human immunodeficiency virus (HIV), Dr Launay and colleagues1 compared four 40-μg intramuscular double doses (IM40 × 4) and four 4-μg intradermal low doses (ID4 × 4) with the standard three 20-μg intramuscular doses (IM20 × 3) of recombinant hepatitis B vaccine. Compared with the standard, there was significant improvement in serological response with both tested regimens. However, escalating vaccine doses are intuitively less desirable if they result in more adverse events.
Bélec L, Authier F, Gherardi RK. Safety and Immunogenicity of Hepatitis B Vaccine Regimens in Adults With HIV-1. JAMA. 2011;306(2):156-157. doi:10.1001/jama.2011.943