HIV and Hepatitis B

Hepatitis B can easily be prevented – also if you are HIV positive. After three vaccination shots, you will be protected for the rest of your life. At the GGD, these vaccination shots are free for gay and bisexual men. Because people with HIV may have a weakened immune system, the vaccine may be somewhat less effective. For that reason, you will receive a double dose of the vaccine each time you come for your vaccination shots. You might also be told to consult with your HIV internist about the best approach. Are you currently infected with Hepatitis B? If you are not receiving treatment for your HIV infection, you will be more likely to get liver disease from Hepatitis B. That means that Hepatitis B is another good reason to start treatment for your HIV immediately. Heb je op dit moment een hepatitis B infectie? Leverziekte door hepatitis B kan sneller optreden als je hiv-infectie niet behandeld wordt. Hepatitis B vormt dus een extra reden om meteen met hiv-behandeling te beginnen.

Getting vaccinated

Hepatitis B can easily be prevented – even if you are HIV positive. Get vaccinated for free. Your HIV internist or your family doctor can give you the vaccination shots directly or he or she can send you to the GGD with a referral letter. The Hepatitis B vaccination is free at the GGD for gay and bisexual men.

Three shots

For complete and probably life-long protection against Hepatitis B, you will need to have three vaccination shots. One month after the first vaccination, you will go back for a second shot. Five months after the second shot, you will get your third and final shot. If you have HIV, the schedule will be the same, but you will get a double dose of the vaccine each time. You will need to go a total of three times, just like everyone else.  

Titre tests

For over 95% of healthy adults, three shots are enough to provide lifetime protection. For a small group of people that will not immediately be the case, however. There is a greater chance that you will not be fully protected against Hepatitis B after a single series of three vaccination shots if you have HIV or Hepatitis C, or if you are above the age of 40. If you have HIV or Hepatitis C or are over 40, it is smart to have a blood test done four to six weeks after your final shot. That way, you can see if the vaccination shots you received have resulted in enough antibodies in your blood, and thus if you are fully protected. This blood test is called a "titre test". A titre test is not free, but often your health insurance will pay for it – unless you haven't used up the amount that you need to pay (i.e. the obligatory deductible policy excess) before your full health insurance coverage starts. If you are being treated for HIV, you have probably already used up that amount.

If it turns out that you need a second series of vaccination shots because the first series didn't have the desired effect, the extra shots will be free.

Sometimes vaccination will be postponed

In the following cases, your HIV internist is likely to wait with prescribing the Hepatitis B vaccination until you have started treatment against your HIV:

  • if you have fewer than 350 CD4 cells per mm3 of blood
  • if the HIV in your blood is not undetectable

You can only be vaccinated against Hepatitis B if your HIV is undetectable and if you have enough CD4 cells.

Prevent double or triple infections with Hepatitis A, B and C

Do you have Hepatitis B? If you also have HIV, having a double infection (Hepatitis B and C)  or a triple infection (A, B and C) can have very serious consequences. Do your best to prevent yourself from getting Hepatitis C if you already have Hepatitis B or Hepatitis A. Unfortunately there is no vaccine against Hepatitis C.

Do you have a chronic Hepatitis C infection but have not yet been vaccinated against Hepatitis B? In that case, get that vaccination as soon as possible. The same holds with regard to Hepatitis A. You can also get vaccinated against that.

Treatment that works against both HIV and Hepatitis B

If you are HIV positive, your HIV internist will probably advise you to choose a combination therapy against HIV that includes the HIV inhibitor tenofovir. The nice thing about this medication is that it works against both HIV and Hepatitis B.



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Preventing Hepatitis B

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