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Pediatric vaccines in HIV-infected children

Jan M Agosti1

  • 1Bill & Melinda Gates Foundation, Seattle, Washington, USA.

Current Opinion in HIV and AIDS
|April 18, 2009
PubMed

Insights

Pediatric immunization for HIV-infected children includes routine inactivated vaccines and specific live attenuated vaccines like MMR and varicella if not severely immunocompromised. Human papillomavirus vaccine is recommended for girls.

Area of Science:

  • Pediatric Infectious Diseases
  • Immunology
  • HIV Medicine

Background:

  • Current pediatric immunization guidelines for children with human immunodeficiency virus (HIV) infection require review.
  • Understanding immune reconstitution and vaccine efficacy in HIV-positive children is crucial.

Purpose of the Study:

  • To review current pediatric immunization recommendations for HIV-infected children.
  • To provide updated guidance on vaccine use in the context of HIV infection.

Main Methods:

  • Review of current pediatric immunization guidelines.
  • Analysis of recent findings and conclusions regarding vaccine safety and efficacy in HIV-infected populations.

Main Results:

  • Routine inactivated vaccines are recommended despite potentially suboptimal immune responses.
  • Live attenuated vaccines are generally not advised, except for measles, mumps, rubella (MMR) and varicella vaccines in non-severely immunocompromised children (CD4 >15%).
  • Human papillomavirus (HPV) vaccine is recommended for girls due to increased anogenital cancer risk in HIV infection. Bacillus Calmette-Guerin (BCG) vaccine is not recommended for HIV-infected infants.

Conclusions:

  • Immunization is generally recommended for HIV-infected children, balancing risks and benefits.
  • While some vaccines may elicit suboptimal responses, the benefits of preventing infectious diseases outweigh theoretical risks of transient HIV viral load increase.
  • Further research is pending on rotavirus and HPV vaccines in HIV-infected populations.
Abstract

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