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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