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Hepatitis Vaccine: An Important Part of AIDS Treatment Strategy?
Jan 3, 2002

Hi, I'm a 43 year old male with AIDS. Currently CD4 count is in the low 300's (was once as low as 24) and viral load is undetectable. I did have the Hepatitis B shots back in the mid-1980's. Recently, when liver function tests were high, I was tested for Hepatitis A, B, and C. All were negative. Just a few questions about this -

1. Are Hepatitis A & B vaccines usually recommended as part of an overall AIDS treatment strategy? 2. Since my Hep B test was negative, does this mean that the vaccine needs to be repeated? or boosted? 3. Can the Hepatitis A and B vaccines be given at the same time?

Response from Dr. Pavia

Good questions. Hepatitis A vaccine is useful for travelers, gay men, drug users and persons with liver disease (and possibly parents with small children). For this reason, it makes sense for most people with HIV and is routinely recommended. Hepatitis B is transmitted through the same routes as HIV so is recommended for persons with HIV who haven't yet been infected.

2. This is a controversial area. One of the most common approaches for someone with a negative antibody test after Hep B vaccine is to give one booster and check for an antibody response. However, this remains controversial since the rate of chronic infection after getting all 3 doses is very low even in people with negative antibody tests, suggesting most of them are protected anyway.

3. Yup, they are often given together and at least one company is trying to combine them in a single syringe.

ATP



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