title: Hepatitis A immunization in HIV-infected haemophilic patients.
abstract: Forty-seven HIV-infected haemophilic patients were entered into a hepatitis A vaccination programme. 10 patients (21%) were lgG seropositive for hepatitis A consistent with past exposure. Of the 37 patients offered vaccination, one refused and 31 completed the vaccination course, 17/13 (55%) seroconverted, nine after the second and eight after the third injection, and 14 patients failed to seroconvert. The CD4 lymphocyte counts immediately prior to vaccination were significantly higher in the patients who developed immunity compared to the nonresponders (median CD4 count in the immune group 380 × 10(6) /1 (range 170-1290), median CD4 count in nonimmune group 110 × 10(6) /1 (range 10-590), P== 0.003). No patient with a CD4 count < 170 × 10(6) /1 seroconverted and five patients with well-preserved CD4 counts also failed to seroconvert. We conclude that HIV-infected haemophilic patients, especially those with more advanced disease, have an impaired response to hepatitis A vaccination. Due to the likely failure of response in patients with CD4 counts < 150 × 10(6) /1, it is reasonable not to include these patients in a hepatitis A vaccination programme.
authors.affiliation: Director, Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH.*Registrar in Haematology, Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham.Clinical Scientist, Public Health Laboratory, Heartlands Hospital, Birmingham.Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham.Clinical urse Specialist, Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham.
authors.forename: J T
authors.initials: JT
authors.lastname: Wilde
authors.affiliation: Director, Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH.*Registrar in Haematology, Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham.Clinical Scientist, Public Health Laboratory, Heartlands Hospital, Birmingham.Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham.Clinical urse Specialist, Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham.
authors.forename: N
authors.initials: N
authors.lastname: Rymes
authors.affiliation: Director, Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH.*Registrar in Haematology, Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham.Clinical Scientist, Public Health Laboratory, Heartlands Hospital, Birmingham.Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham.Clinical urse Specialist, Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham.
authors.forename: S
authors.initials: S
authors.lastname: Skidmoe
authors.affiliation: Director, Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH.*Registrar in Haematology, Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham.Clinical Scientist, Public Health Laboratory, Heartlands Hospital, Birmingham.Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham.Clinical urse Specialist, Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham.
authors.forename: M
authors.initials: M
authors.lastname: Swann
authors.affiliation: Director, Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH.*Registrar in Haematology, Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham.Clinical Scientist, Public Health Laboratory, Heartlands Hospital, Birmingham.Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham.Clinical urse Specialist, Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham.
authors.forename: J
authors.initials: J
authors.lastname: Linin
keywords: HAVRIX; HIV; haemophilia; hepatitis A; immunizatino