title: Long-term durability of immune responses after hepatitis A vaccination among HIV-infected adults.
abstract: BACKGROUND
  Vaccination provides long-term immunity to hepatitis A virus (HAV) among the general population, but there are no such data regarding vaccine durability among human immunodeficiency virus (HIV)-infected adults.
  
  
  METHODS
  We retrospectively studied HIV-infected adults who had received 2 doses of HAV vaccine. We analyzed blood specimens taken at 1 year, 3 years, and, when available, 6-10 years postvaccination. HAV immunoglobulin G (IgG) values of ≥10 mIU/mL were considered seropositive.
  
  
  RESULTS
  We evaluated specimens from 130 HIV-infected adults with a median age of 35 years and a median CD4 cell count of 461 cells/mm(3) at or before time of vaccination. Of these, 49% had an HIV RNA load <1000 copies/mL. Initial vaccine responses were achieved in 89% of HIV-infected adults (95% confidence interval [CI], 83%-94%), compared with 100% (95% CI, 99%-100%) of historical HIV-uninfected adults. Among initial HIV-infected responders with available specimens, 90% (104 of 116; 95% CI, 83%-95%) remained seropositive at 3 years and 85% (63 of 74; 95% CI, 75%-92%) at 6-10 years. Geometric mean concentrations (GMCs) among HIV-infected adults were 154, 111, and 64 mIU/mL at 1, 3, and 6-10 years, respectively, compared with 1734, 687, and 684 mIU/mL among HIV-uninfected persons. Higher GMCs over time among HIV-infected adults were associated with lower log(10) HIV RNA levels (β = -.12, P = .04).
  
  
  CONCLUSIONS
  Most adults with well-controlled HIV infections had durable seropositive responses up to 6-10 years after HAV vaccination. Suppressed HIV RNA levels are associated with durable HAV responses.
authors: Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA. nancy.crum@med.navy.mil
authors: Nancy F
authors: NF
authors: Crum-Cianflone
authors: Kenneth
authors: K
authors: Wilkins
authors: Andrew W
authors: AW
authors: Lee
authors: Anthony
authors: A
authors: Grosso
authors: Michael L
authors: ML
authors: Landrum
authors: Amy
authors: A
authors: Weintrob
authors: Anuradha
authors: A
authors: Ganesan
authors: Jason
authors: J
authors: Maguire
authors: Stephanie
authors: S
authors: Klopfer
authors: Carolyn
authors: C
authors: Brandt
authors: William P
authors: WP
authors: Bradley
authors: Mark R
authors: MR
authors: Wallace
authors: Brian K
authors: BK
authors: Agan
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