Routine vaccination in HIV-infected patients: a review

This paper reviews the literature from 1988 to November 1993 on the effectiveness of routine vaccination of HIV-infected adults. Data on the clinical benefit of vaccination in this particular group of patients are not available. In general, HIV-infected patients have suboptimal immunological responses to vaccines. In particular, an impaired responsiveness is found in patients with fewer than 200 x 10(6) CD4+ cells per litre. Consequently, it seems prudent to offer active immunization to HIV-infected subjects who are relatively immunocompetent. However, the usefulness of vaccination in those subjects who have a low CD4+ cell count is doubtful.