Drugs

, Volume 68, Issue 11, pp 1473–1481

Immunization in Patients with HIV Infection

Are Practical Recommendations Possible?
Current Opinion

DOI: 10.2165/00003495-200868110-00001

Cite this article as:
Eley, B. Drugs (2008) 68: 1473. doi:10.2165/00003495-200868110-00001

Abstract

The purpose of this article is to review immunization recommendations for HIV-infected individuals in resource-constrained countries, particularly in sub-Saharan Africa.

Recent evidence suggests that HIV-infected children are at risk for low immunization coverage in sub-Saharan Africa. Routine immunization is recommended for these children. In comparison with immunocompetent children, recommendations for live-attenuated vaccines differ in HIV-infected children. However, limited laboratory capacity to diagnose HIV infection amongst young children prevents the implementation of these HIV-specific guidelines in resource-constrained countries. Re-immunization has been the focus of recent research in high- and middle-income countries. Findings show that children established on highly active antiretroviral therapy have suboptimal vaccine-specific immunity and may benefit from re-immunization. Before re-immunization guidelines can be formulated for resource-constrained countries, several questions should be addressed, including whether all HIV-infected children will benefit from routine re-immunization and what optimal number of vaccine doses should be administered. Pneumococcal and influenza infections are important causes of morbidity and mortality amongst HIV-infected individuals. There is compelling evidence showing that pneumococcal conjugate vaccines will protect HIV-infected and uninfected children against invasive infection. Pneumococcal conjugate vaccines should be prioritized for introduction in countries with high HIV prevalence. Although, annual influenza immunization is recommended for HIV-infected individuals, the effectiveness in Africa remains unclear.

In conclusion, this brief overview has identified several limitations of current immunization policy and practice for HIV-infected individuals living in resource-constrained countries.

Copyright information

© Adis Data Information BV 2008

Authors and Affiliations

  1. 1.Paediatric Infectious Diseases UnitRed Cross Children’s Hospital, School of Child Rondebosch and Adolescent HealthCape TownSouth Africa

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