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The newspaper of The Johns Hopkins University May 1, 2006 | Vol. 35 No. 32
Docs Should Confirm Hepatitis A in HIV-Positive Kids After Vaccination

Hepatitis A vaccination is safe in HIV-infected children but may be less effective in creating immunity than it is in healthy children. Therefore, health care providers of HIV-infected children should confirm their immunity after vaccination, according to the findings of a new study from Johns Hopkins Children's Center.

HIV-positive children are at a greater risk of bacterial and viral infections, including hepatitis A, than healthy children. Hepatitis A can damage the liver, an organ that might be already compromised in children with HIV because of antiviral medications and HIV-related opportunistic infections.

"We know it's important to prevent hepatitis A infection in children with HIV," said the study's senior author, George Siberry, assistant professor of pediatrics. "However, we've had very little information about how their HIV infection might prevent them from responding to the hepatitis A vaccine. This study helps answer that question."

Researchers analyzed the blood samples of 81 HIV-positive children who had completed a two-shot series of hepatitis A immunization. Of the 81 children, 70 (86 percent) had developed hepatitis A antibodies following immunization. Overall, patients younger than 15 and those infected with HIV during birth were more likely to develop immunity following immunization for hepatitis A.

In one of three children who had not developed immunity after the standard two doses of hepatitis A vaccine, a third dose produced blood antibodies. Researchers say a third dose should be considered in children who fail to respond to two. Investigators observed no adverse side effects following immunization. Further studies are needed to determine how long hepatitis A immunity lasts in vaccinated HIV-positive children.


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