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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
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Is Hep Vaccine Medically Necessary?
Jan 7, 2012

I was HIV diagnosed in 2006, Even though i cannot seem to achieve undetectable status, my labs are currently at 150 viral and 550 CD4 with no resistance. I travel internationally for work. In conversations with local residents, many seem to be more concerned about hepatitis then HIV especially in Great Britain. As a result I asked my doctor for a hepatitis test which came back negative. My doctor suggested I be vaccinated against hepatitis A and B with the Twinrix vaccine. However my insurance company states they need a "medical necessary" statement before they will pay for the roughly $400 for the series of medication. My doctor has written a generalized statement that, "I have HIV and need the vaccine". Knowing the insurance companies policies of tripping over dollar bills to pick up pennies, I know they are going to want something more specific. I alreay have enough issues without being co-infected. What would you suggest the medical necessity be in order to obtain a favorable outcome?

Thank you, Pillboy

Response from Dr. McGovern

In 2012 the British HIV Medicine Guidelines have been published (HIV Medicine 2012; 13: 1-44.

In section 20.2 of the document, there is a recommendation that all HIV infected patients should be tested for hepatitis A and B and should be vaccinated if never exposed.

In the US, there are the same guideline recommendations from the Dept of Health and Human Services. Here is the reference you can cite for this:

Centers for Disease Control and Prevention. Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents. MMWR 2009;58 (No. RR-4) April 10, 2009

You should be able to get coverage - NO PROBLEM.

Condom came off
GI doc?

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