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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
           
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Vaccine
Feb 9, 2008

Dear Dct. Barbara,

my viral load is undetectable (ultra sens. PCR test) and my CD 4 was: 594 (september07); 447 (March07),616 (Oct06), 395 (Oct05), 541 (May2005). I take lamivudina, zidovudina and efavirenz since Oct2002 and I have a 100% adherence. My results in July 2002 was 10,000 vl and Cd4 220. I maintain assyntomatic and detected I was pos. when realized exams before my wife desire to be pregnant. I maintain the undetectable viral load since December 2002. In 2006 I took vaccine for Pneumo23, three doses (2,0 ml each after one month) for Hepatitis B, dT (difteria/tetano, and hepatitis A ( I lost the second dose. Next month I will need to travel to Colombia and the country needs vacination for YELLOW FEVER. This vacine use live virus. My doctor has governemment orientation about advice the vacine for assyntomatic HIV + with CD4 greater than 200. I would like your advice about missed dose Hepatitis A and the vacination for yellow fever. I was recommend to avoid vl analysis and cd4 after one month, because the vacination can modify these values. May I take the both vacines? Please comment the schedulle,like when to take, because the interation and the time to be effetive. Thanks for your attention.

Klaus Kohl

Response from Dr. McGovern

I would simply retake the hepatitis A series if your antibody levels do not show protection.

HIV infected patients with CD4 counts >200 cells can take yellow fever vaccine.



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