Immunogenicity and safety of a pediatric dose virosomal hepatitis A vaccine in Thai HIV-infected children

The immunogenicity and safety of a pediatric dose of a virosomal hepatitis A vaccine (Epaxal?) was evaluated in a group of 45 Thai children with human immunodeficiency virus (HIV) infection, age 2-16 years. Vaccines were administered at 0 and 6 months. Anti-HAV antibody titers were measured at baseline (before injection) 1 and 7 months after primary vaccination. The prevalence of HAV protective antibody in 45 Thai HIV-infected children was 13.6%. The seroprotection rate was 71% at 1 month and 100% at 7 months. The booster dose increased geometric mean concentration (GMC) from 106.5 mIU/ml to 3486.1 mIU/ml. Higher CD4 lymphocyte counts at enrollment was a predictive factor for HAV antibody response. Both doses of Epaxal? were well tolerated. These preliminary data suggest that a pediatric dose of Epaxal? is an effective hepatitis A vaccine for HIV-infected children and should be considered for implementation on a larger scale in the pediatric HIV population.