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Reuters Health Information (2011-06-10): Hep A vaccine response persists in well-controlled HIV


Hep A vaccine response persists in well-controlled HIV

Last Updated: 2011-06-10 16:31:16 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Hepatitis A vaccine immunity persists for long durations in patients with well-controlled HIV, new research shows.

A decade after vaccination, three quarters of vaccinated patients still had protective antibodies, the researchers found.

"These data suggests that HIV patients may not need booster doses of HAV (Hepatitis A virus) vaccine for the first 10 years after vaccination," said lead researcher Dr. Nancy F. Crum-Cianflone from the Naval Health Research Center, San Diego, California in an email to Reuters Health.

But, she emphasizes, the patients in the study had early diagnosis and treatment of their HIV infection.

As reported June 15th in the Journal of Infectious Diseases, Dr. Crum-Cianflone and her team analyzed protective antibody levels following the standard two doses of HAV vaccine in 130 HIV-infected adults. At baseline, the median CD4 count was 461 cells/mm3, 49% of patients had HIV RNA levels below 1000 copies/mL, and 62% were receiving highly active antiretroviral therapy (HAART).

Blood samples were tested for anti-HAV immunoglobulin G at one, three, six and 10 years post-vaccination. Antibody titers of at least 10 milli-international units (mIU)/mL were considered protective.

At one year, 89% of patients had protective levels of anti-HAV antibodies. Among these responders, 90% and 85% still had protective levels at six and 10 years, respectively.

Geometric mean concentrations of antibodies at six and 10 years were significantly greater in patients with HIV RNA below 1000 copies/mL and no more than 350 CD4 cells/mm3.

The research team also reports that higher geometric mean antibody concentrations over time were associated with lower HIV viral loads.

"Those with suppressed HIV RNA levels were more likely to have durable responses, suggesting that good vaccine response may be another benefit of being on HAART and maintaining good HIV control," Dr. Crum-Cianflone said in her email.

"There is no data to support higher dose of HAV vaccine in HIV-infected persons than in the general population," Dr. Turner Overton from Washington University School of Medicine said in an email to Reuters Health.

Dr. Overton, who was not connected to Dr. Crum-Cianflone's study, recommends baseline HAV screening and vaccination for all HIV patients. "The utility of long term evaluation of HAV antibodies and booster doses of HAV vaccine remains to be evaluated," he said.


J Infect Dis 2011; 201:1815-1823.

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