Nonresponse to hepatitis b vaccine in homosexual men

Of 479 homosexual men immunized with three 20-μg doses of the hepatitis B vaccine, ∼15% failed to develop protective titers of antibody to the surface antigen of hepatitis B virus (>10 sample ratio units [SRU]). We revaccinated 34 nonresponders with an additional three doses of vaccine and compared their immunologic status with that of 14 control men who had responded to initial vaccination. Most men (1S of 19) who had measurable antibody to hepatitis B surface antigen (SRU, 2.1-9.9) after initial vaccination responded to revaccination, whereas ten of the remaining 15 nonresponders (SRU, <2.1) did not. No single immunologic measure distinguished ultimate responders from nonresponders; however, the initial responders differed from delayed responders and nonresponders by having higher numbers of total lymphocytes, B, T, and T helper and suppressor cells.