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HBV Vaccination
Apr 1, 2006

Dear Dr. McGovern, I am HIV + and have HBV. My CD4 count is around 500, hiv viral load is undetectable <50, HBV antigen is negative, HBV DNA is undetectable <50 copies, but HBV antibodies are negative. I completed the 3 HBV shots a year ago but I am not producing antibodies to HBV. Do you recommend me getting the 3 HBV shots again? My Gastroentrologist said that I didn't need to as he didn't think it would do any good but my thinking is what would it hurt to try the series of vaccinations again to possibly build antibodies to HBV? What do you think? Thanks for your time and response.

Response from Dr. McGovern

Thank you for your excellent question.

I think it is at least reasonable to try a booster shot (one additional dose) to see if you seroconvert.

If your CD4 count recently became higher, I would wait about six months and try another round of immunization. Sometimes, the number of T cells go up but not all memory and naive T cells have come back yet. These are the cells that help you respond to vaccine. Full immune reconstitution secondary to HAART can take time.

In the meantime, be certain to protect yourself against HBV exposures.

Dr. M



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