Hepatitis A vaccine responses in HIV-positive persons with haemophilia

The safety and immunogenicity of subcutaneously (s.c.) administered hepatitis A (HA) vaccine was evaluated in HIV positive and negative patients with haemophilia and healthy male controls. The vaccine was well tolerated. Seroconversion occurred among all controls after one dose of vaccine but was delayed among patients, particularly if HIV-positive-4 of 17 (24%) failed to respond to three doses of vaccine. Following the third dose of vaccine, geometric mean titres were significantly higher among controls (1354) than among HIV infected patients (204) (P <0.05). Non-responders failed to develop an immune response following boosting with high titre vaccine. Patients with haemophilia may be vaccinated against HA s.c. but consideration should be given to ensuring that HIV-positive individuals with haemophilia and other immunosuppressed individuals should have their immune responses checked since additional booster doses or passive prophylaxis may be necessary in such individuals.