Role of CD4 count in immunity development after hepatitis A and B vaccination among HIV-infected patients: Kentucky, 2002-2007

Purpose: To determine whether lower prevaccination CD4 counts decrease odds of immune development against hepatitis A virus/hepatitis B virus (HAV/HBV) among patients who receive the vaccine and examine the relationship between vaccine response and sex, race/ethnicity, health insurance status, tobacco use, substance abuse, or comorbidities. Methods: This study was performed among patients who received the standard dose for HAV and/or HBV vaccine. Results: Among 76 HIVinfected patients, immunity development to HAV or HBV increased as CD4 counts increased. In addition, males had greater vaccine response than females. Whites were observed to have higher rates of immunity than other races/ethnicities. Patients with private insurance had greater vaccine response than those with Medicaid, Medicare, or no insurance. Patients not experiencing hypertension and hyperlipidemia developed immunity more often than patients with these comorbidities. Substance abuse and tobacco use were also associated with lower vaccine response. Conclusions: Higher CD4 counts improved likelihood of patients developing an antibody response after vaccination.