The U.S. Department of Health and Human Services and the Infectious Disease Agency of America's gave guidelines for the prevention of opportunistic infections in persons with human immunodeficiency virus (HIV).
The guidelines recommend that all susceptible HIV positive patients at increased risk for Hepatitis A or with chronic liver disease, be vaccinated against Hepatitis A.
Immune response to Hepatitis A vaccine has not been well studied in HIV positive patients.
In particular, there is little information in the literature regarding the effect and relationship of the CD4 count and the immune response in HIV patients.
Dr Sharon Weissman and colleagues performed a retrospective analysis of HIV positive patients who received Hepatitis A vaccine.
The research team then measured the antibody response to Hepatitis A.
Univariate and multivariate analyses were performed to determine predictors of response to vaccine administration.
|48% of HIV patients responded to Hep A vaccine vs 100% reported in HIV negative patients|
|Journal of Viral Hepatitis|
Of the 503 patients evaluated, 138 patients completed their Hepatitis A vaccination series.
The research team reported that 48% of the patients had postvaccine anti-Hepatitis A positive results, and termed this patient group the responders.
The team found no difference in age, race, antiretroviral therapy use, or Hepatitis C virus exposure between responders and nonresponders.
In univariate analysis, the team noted that responders were more likely to be females.
The researchers also noted that responders had a higher CD4 count at vaccine, and marginally lower viral load at vaccine.
Dr Weissman's team concluded, “Multivariate analysis showed that female gender and higher CD4 count at vaccine were independent predictors of response to vaccine.”
“About 48% of the HIV positive patients responded to Hepatitis A vaccine administration.”
“This is much lower than reported rates of 100% in HIV-negative patients.”
“Female gender and CD4 count at vaccine, but not CD4 nadir, predicted response to vaccine.”