Current Infectious Disease Reports

, Volume 6, Issue 5, pp 399–403 | Cite as

International travel: Recommendations for the HIV-infected patient

  • Lisa A. Spacek
  • Thomas C. Quinn
Article

Abstract

In order to prevent travel-related diseases in patients infected with HIV, pretravel planning that includes vaccination, chemoprophylaxis, and behavioral modification is recommended. Many HIV-infected individuals successfully treated with highly active antiretroviral therapy may travel safely. However, patients with reduced CD4 lymphocyte counts are at increased risk for bacterial, mycobacterial, viral, fungal, and parasitic infections. Recommendations for vaccination and chemoprophylaxis are based on immune status and risk of infection. The efficacy of vaccination is dependant on CD4 lymphocyte count; inactivated and polysaccharide vaccines are considered safe in this population. Behavioral modifications to prevent food- and waterborne disease are an important component of disease prevention. A travel-health practitioner should review travel duration, destination, and activities, and assess the risk-benefit ratio of vaccination and chemoprophylaxis, in order to reduce the likelihood of travel-associated illness.

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References and Recommended Reading

  1. 1.
    Castelli F, Patroni A: The human immunodeficiency virusinfected traveler. Clin Infect Dis 2000, 31:1403–1408. This is a review of issues related to international travel. It includes a table that summarizes vaccine safety and immunogenicity.PubMedCrossRefGoogle Scholar
  2. 2.
    McKenzie R: Travel advice for HIV-infected individuals. Hopkins HIV Rep 2004, 16:9–12. This is a practical discussion of travel-related recommendations, including vaccines, malaria prophylaxis, and traveler’s diarrhea.PubMedGoogle Scholar
  3. 3.
    Kroon FP, van Dissel JT, de Jong JC, et al.: Antibody response after influenza vaccination in HIV-infected individuals: a consecutive 3-year study. Vaccine 2000, 18:3040–3049.PubMedCrossRefGoogle Scholar
  4. 4.
    Tedaldi EM, Baker RK, Moorman AC, et al.: Hepatitis A and B vaccination practices for ambulatory patients infected with HIV. Clin Infect Dis 2004, 38:1478–1484.PubMedCrossRefGoogle Scholar
  5. 5.
    Rousseau MC, Moreau J, Delmont J: Vaccination and HIV: a review of the literature. Vaccine 2000, 18:825–831. This is a review of vaccination in HIV disease that includes data regarding children and adults.CrossRefGoogle Scholar
  6. 6.
    Fuller JD, Craven DE, Steger KA, et al.: Influenza vaccination of human immunodeficiency virus (HIV)-infected adults: impact on plasma levels of HIV type 1 RNA and determinants of antibody response. Clin Infect Dis 1999, 28:541–547.PubMedGoogle Scholar
  7. 7.
    Tasker SA, Treanor JJ, Paxton WB, Wallace MR: Efficacy of influenza vaccination in HIV-infected persons. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1999, 131:430–433.PubMedGoogle Scholar
  8. 8.
    Steffen R, Kane MA, Shapiro CN, et al.: Epidemiology and prevention of hepatitis A in travelers. JAMA 1994, 272:885–889.PubMedCrossRefGoogle Scholar
  9. 9.
    Rojanasuphot S, Shaffer N, Chotpitayasunondh T, et al.: Response to JE vaccine among HIV-infected children, Bangkok, Thailand. Southeast Asian J Trop Med Public Health 1998, 29:443–450.PubMedGoogle Scholar
  10. 10.
    Recommended adult immunization schedule--United States, 2003–2004. MMWR Morb Mortal Wkly Rep 2003, 52:965-970.Google Scholar
  11. 11.
    Tattevin P, Depatureaux AG, Chapplain JM, et al.: Yellow fever vaccine is safe and effective in HIV-infected patients. AIDS 2004, 18:825–827. This retrospective study of 12 HIV-infected patients who received yellow fever vaccine found that risk for adverse outcomes is limited and effectiveness is reliable.PubMedCrossRefGoogle Scholar
  12. 12.
    Cobelens FG, van Deutekom H, Draayer-Jansen IW, et al.:Risk of infection with Mycobacterium tuberculosis in travellers to areas of high tuberculosis endemicity. Lancet 2000, 356:461–465.PubMedCrossRefGoogle Scholar
  13. 13.
    Talbot EA, Perkins MD, Silva SF, Frothingham R: Disseminated bacille Calmette-Guerin disease after vaccination: case report and review. Clin Infect Dis 1997, 24:1139–1146.PubMedGoogle Scholar
  14. 14.
    Khaliq Y, Gallicano K, Tisdale C, et al.: Pharmacokinetic interaction between mefloquine and ritonavir in healthy volunteers. Br J Clin Pharmacol 2001, 51:591–600.PubMedCrossRefGoogle Scholar
  15. 15.
    Colebunders R, Nchega J, Van Gompel A: Antiretroviral treatment and travel to developing countries. J Travel Med 1999, 6:27–31.PubMedCrossRefGoogle Scholar
  16. 16.
    Ericsson CD: Travellers’ diarrhea. Int J Antimicrob Agents 2003, 21:116–124.PubMedCrossRefGoogle Scholar
  17. 17.
    Kaplan JE, Masur H, Holmes KK, et al.: Guidelines for preventing opportunistic infection among HIV-infected persons-2002. Recommendations of the U.S. Public Health Service and the Infectious Diseases Society of America. MMWR Recomm Rep 2002, 51:1–52.Google Scholar
  18. 18.
    Centers for Disease Control and Prevention: National Center for Infectious Diseases—travelers’ health. http://www.cdc.gov/ travel. Accessed June 14, 2004. This is a current source for travel advice, including recent outbreaks, travel medicine, and information specific to travelers’ destinations.Google Scholar
  19. 19.
    United States Department of State: Medical information for Americans traveling abroad. http://www.travel.state.gov/ medical.html. Accessed June 14, 2004.Google Scholar
  20. 20.
    World Heath Organization: International travel and health. http://www.who.int/ith. Accessed June 14, 2004.Google Scholar

Copyright information

© Current Science Inc. 2004

Authors and Affiliations

  • Lisa A. Spacek
    • 1
  • Thomas C. Quinn
  1. 1.Division of Infectious DiseasesJohns Hopkins School of MedicineBaltimoreUSA

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