hep a and hep b vaccine - methotrexate

[ArchivalUser]

read about "Double Dose Hepatitis Vaccine" .. google it..

[ArchivalUser]

yea...thats gud...did nt knw that..thnx buddy.....BUT UPTODATE SAYS BELOW...



PREVENTION — All HIV-infected patients should have serologic testing for HBV and vaccination should be initiated in patients who have no evidence of prior exposure [10,63]. Early vaccination is recommended in such patients because HIV-infected patients with a low CD4 count have a decreased response to immunization [64-67].

Avoidance of exposure to HBV should be emphasized during the vaccination period. Coincidental infection with HBV during immunization has been associated with a high rate of development of chronic HBV infection [64]. Vaccine efficacy of HIV-infected patients and general preventive measures are discussed elsewhere. (See "Immunizations in HIV-infected patients", section on 'Hepatitis B vaccine' and "Epidemiology, transmission and prevention of hepatitis B virus infection".)

Screening tests — The Advisory Committee on Immunization Practices recommends that adults at risk for HBV undergo testing for either hepatitis B surface antigen or antibody to hepatitis B surface antigen (anti-HBs) [68]. A positive test for either marker is interpreted as evidence that the patient has past infection and does not need immunization. However, it is important to realize that testing in this manner would miss opportunities to identify patients who have isolated anti-HBc [69]. As a result, we recommend also testing for anti-HBc.

[ArchivalUser]

given a choice between varicella and hepA vaccine in a asymptomatic HIV pt, what would be the answer, iam sorry iam deviating from the topic but,,

[ArchivalUser]

varicella is a live vaccine and should not be given...
MMR can be given if CD > 400

[ArchivalUser]

Vaccines for HIV patients:
Td, Hep A and Hep B ( if negative serology)
Yearly Influenza vaccine.
MMR and Pneumovac (only if CD4 > 200)

[ArchivalUser]

@dr_gastro : what I meant by double dose was that you give a 2nd dose even to ppl who were previously vaccinated bcos the immunity weakens in such pt and they are not able to mount any response or serology Ab titre.

thanks for the uptodate stuff, it makes the picture clear and yes I was wrong in saying that to give the vaccine if they are seropositive.. I should have elaborated it more.. but with just 24hrs in a day and so much to do.. anyways thanks a ton.