Hepatitis A in HIV-positive people

The epidemiological and clinical manifestations of HIV/hepatitis A co-infection have not been well studied. Unlike with hepatitis B and C, research to date generally does not suggest that hepatitis A is more severe in HIV-positive individuals or vice versa.

The hepatitis A vaccine, which is made with inactivated virus, is safe and effective in people with HIV. However, severely immunocompromised individuals may not produce an adequate supply of antibodies and may be more likely to lose protective immunity over time.1,2,3,4 This suggests that vaccination should be done early in the course of HIV disease, before immune function has declined. If a person presents with compromised immunity, use of antiretroviral therapy to raise the CD4 cell count may improve vaccine response.

References

  1. Bodsworth NJ et al. The effect of immunization with inactivated hepatitis A vaccine on the clinical course of HIV-1 infection: 1-year follow-up. AIDS 11: 747-749, 1997
  2. Kemper CA et al. Safety and immunogenicity of hepatitis A vaccine in HIV-infected patients: A double-blind, randomized, placebo-controlled trial. Journal of Infectious Diseases, 187, on-line edition, 2003
  3. Santagostino E et al. Patterns of immunogenicity of an inactivated hepatitis A vaccine in anti-HIV positive and negative hemophilic patients. Thromb Haemost 72: 508-510, 1994
  4. Wallace MR et al. Safety and immunogenicity of an inactivated hepatitis A vaccine among HIV-infected subjects. Clin Infect Dis 39: 1207-1213, 2004
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