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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
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No immunity for hep b
Oct 13, 2012

After 3 hepatitis B injections I still have no immunity for it. What does this mean?

Response from Dr. Taylor

There are several reasons why people may not respond to the hepatitis B vaccine, meaning not developing the hepatitis B surface antibody (sAb).

First, people who already have chronic hepatitis B will not respond to the vaccine. So, it is important to test for this with a blood test for the hepatitis B surface antigen (sAg).

Second, some people have health issues that make it difficult to develop the hepatitis B surface antibody. These health issues include HIV infection, other types of immunosuppressed states (diseases that cause a weakened immune system) and chronic kidney disease. Check with your doctor if you fall into one of these categories, or if you do not know whether you do. For example, if you have not had an HIV test, this is a good test to consider. For people with some of these health issues, there are recommendations about increasing the doses of the hepatitis B vaccine or giving the vaccine in a slightly different way, so check with your doctor about this.

Third, some people inherited genes (your biologic parents passed on this trait) that make it hard to respond to the vaccine, although this is rare.

Finally, there are times when the vaccine was not given correctly. For example, it may not have been given in the right part of the body, injected into the muscle, or for people who are overweight, given with a longer needle. The vaccine has to be kept within a certain temperature range and expires over time, so if these instructions were not followed, the vaccine may not be effective.

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