Carlos Fritzsche1, M Loebermann2, E C Reisinger2. 1. Division of Tropical Medicine and Infectious Diseases, Department of Medicine, University of Rostock Medical School, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany. Carlos.Fritzsche@med.uni-rostock.de. 2. Division of Tropical Medicine and Infectious Diseases, Department of Medicine, University of Rostock Medical School, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany.
Abstract
BACKGROUND: Vaccination against hepatitis A virus infection is recommended for men who have sex with men and other risk groups. The protection offered by the combined hepatitis A and B vaccine is comparable to that offered by the monovalent hepatitis A vaccine. CASE: A 38-year-old HIV-positive patient presented with right upper abdominal pain, fever and jaundice. Serological work-up and detection of hepatitis A RNA in stool sample revealed an acute hepatitis A infection despite a previous complete vaccination with the combined hepatitis A and B vaccine. CONCLUSION: Although the combined hepatitis A and B vaccine is associated with very good seroconversion rates, the effectiveness in HIV-positive patients is not ensured, even in cases with CD4 cell counts of > 500/μl. Therefore, regular post-vaccine testing should be encouraged to assess seroconversion in immunocompromised subjects.
BACKGROUND: Vaccination against hepatitis A virus infection is recommended for men who have sex with men and other risk groups. The protection offered by the combined hepatitis A and B vaccine is comparable to that offered by the monovalent hepatitis A vaccine. CASE: A 38-year-old HIV-positive patient presented with right upper abdominal pain, fever and jaundice. Serological work-up and detection of hepatitis A RNA in stool sample revealed an acute hepatitis A infection despite a previous complete vaccination with the combined hepatitis A and B vaccine. CONCLUSION: Although the combined hepatitis A and B vaccine is associated with very good seroconversion rates, the effectiveness in HIV-positive patients is not ensured, even in cases with CD4 cell counts of > 500/μl. Therefore, regular post-vaccine testing should be encouraged to assess seroconversion in immunocompromised subjects.
Authors: Patrick A Bovier; Jürgen Bock; Tiziana Farinelli Ebengo; Gert Frösner; Jacqueline Glaus; Christian Herzog; Louis Loutan Journal: J Med Virol Date: 2010-10 Impact factor: 2.327
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