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Hepatitis Vaccine and Blood Test Results?
Sep 14, 2005

Hi Doctors,

Thanks for your website.

My girlfriend recently had the third (and final) jab in her series of vaccines for hepatitis B. Her labs prior to this were CD4 670 and VL 6000. The vaccine made her feel like she had flu for a few days after, but the doctor said that this was to be expected. She had a blood test in the week after having the vaccine, and her viral load had jumped (slightly, but not overly significantly), but her CD4 had dropped to 480. Her CD4% however, stayed the same. Is such a large drop common after a Hep B vaccination, and will the next labs have a chance of CD4's increasing again? As her viral load has been so low for so long (about 6000), a huge drop is of big concern to both of us.

Also, do you recommend Hep B vaccine for all HIV+ people?

Please advise and put our minds at rest! Many thanks! :)

Response from Dr. Wohl

Vaccines can cause a brief (and usually small) increase in viral load that is not thought to be clinically significant as the viral load returns to pre-vaccine levels quickly. That the CD4 % stayed the same suggests to me that this count has not really changed much. The CD4 % is a measure of the proportion of white blood cells that are CD4 cells. If the CD4% is unchanged, it means the over all white blood cell count has fluctuated but the CD4 pool of cells is staying about the same. I understand your concern, but would not worry.

Hepatitis B vaccine is a good idea for people with HIV who do not have immunity to this virus from prior exposure. Hepatitis B can be a nasty infection and is tremendously more contagious than HIV (i.e. it is easier to catch).

DW



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