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Hepatitis vaccine & ELISA - confused, please help!
Aug 8, 2004

Hello Dr. Bob,

First, I would like to thank you for providing such an incredible resource to the community. With all you have on your plate, its amazing you have time to do any of it, but please know it is appreciated... your candor, wit and expertise has made this whole ordeal (somewhat) bearable....

Now my question, which I cannot find an answer to in the archives. I am in my 15th week following a high risk exposure for which I was on PEP (condom failure vaginal insertive). I have taken tests at 8 weeks (ELISA & PCR-DNA) and 13 weeks (ELISA) - all negative. I remain a little worried because I have some lingering symptoms (the most significant being slightly achy (but not swollen) lymph nodes)

When I went to the Dr. today, he reviewed my bloodwork taken at the same time as the 13 week test and mentioned I had no immunity to Hep A or B. This concerned me because I was vaccinated against both 6 months ago for a trip I took. He told me he would do both then and there and I said OK. Two questions:

1. Should I be worried about the failure to produce antibodies to Hep A&B following the vaccine? (i.e. does this make me someone who is slow to produce antibodies?)

2. Because of my symptoms, I am planning to take another test at 17 weeks as recommended by some. Is there a chance that the Hep vaccines could cause a false positive on the ELISA I am taking in 2 weeks? (some sources indicate this could happen, but don't say how long one should wait after getting the vaccine).

Please help!

-confused & worried

P.S. - I really should have added a 3rd question that I cannot figure out - why is it that so many heterosexual men find you so attractive?? I have to admit, I'm guilty of the same, even though I am firmly in the hetero camp (nothing against it, I'm just not wired that way) Anyway, I'm sure Steve has nothing to worry about... I do, however, have some female friends who would love to get their hands on that "new cologne" you are talking about....

P.P.S - thanks for the handsigned note following my donation... you don't really sign all those yourself do you????

Response from Dr. Frascino

Hi,

Thanks for your kind words.

To answer your specific questions:

1. No, you should not be worried. Failure to produce detectable antibodies following hepatitis vaccination can be related to many potential factors. I won't bore everyone with the details here, but I will mention it took me three sets of hepatitis B vaccines for it to finally kick in and work! What is important is to point out that failure to respond to hepatitis vaccines is not related to the body's ability to make antibodies directed towards an active infection (HIV infection, for instance).

2. No, hepatitis vaccinations will not alter HIV test results, inhibit the production of anti-HIV antibodies, or change the duration of the window period.

3. Maybe it's the new cologne, but in general gay Italian sexperts have always been popular at camp hetero.

You are very welcome for your hand-signed note. Yes, I do sign each and every one! (I fold them up, stuff them in the envelope, stamp and post them as well.)

Stay well. Your results to date are extremely encouraging!

Dr. Bob



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