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Yellow Fewer Vaccine
Nov 23, 2005

Dr, I have been on Viramune and Combivir for the past 5 years. I have high T-Cell count and undetectable virus levels. I have to travel to Lagos in Nigeria and must have Yellow Fever Vaccine. Is this a problem for me as a HIV+ person? Joe

Response from Dr. Young

Thanks for your post.

Yours is an important question-- yellow fever can be a devastating illness, with no specific treatment. Because of this, it's recommended that travellers to endemic regions consider yellow fever vaccination.

The problem is that the vaccine is a live virus and therefore might have an increased risk of complications among persons with impaired immunity, such as HIV-infected persons (this is in contrast to inactivated vaccines, like influneza A or pneumococcal vaccines). Because of this, I don't recommend the vaccine unless there's a real need.

Fortunately, there are a number of cohort studies that show that among HIV-infected persons with higher CD4 counts, the rates of complications from the vaccine are essentially the same as the HIV-negative population. You've not mentioned your CD4 cell count, but since you've been on meds for 5 years, my guess is that it's probably pretty good. If your CD4 count is about or above 350, yellow fever vaccine should be safe to admininster.

Good luck, travel safe. BY

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