Sixth International Congress

Drug Therapy in HIV Infection


17-21 November, 2002
Glasgow, UK

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The use of prophylactic vaccines in HIV-infected individuals

Frank Kroon 1
Int Cong Drug Therapy HIV 2002 Nov 17-21;6:Abstract No. PL10.4

Vaccination is an excellent and easy way to protect individuals against a variety of infectious diseases. Whether vaccination is beneficial for the individual depends on the incidence of the relevant disease, the rate of protection induced by the vaccine and the potential side effects of the vaccination. Due to the immunodeficiency in HIV-infected individuals some immunizations will fail to induce a substantial antibody response, particularly when CD4+ Tlymphocytes are <200/mm3. Vaccination against influenza, pneumococcal disease, hepatitis B and A are generally recommended.

The sometimes observed vaccination-induced HIV-replication appears to be limited and transient. Live vaccines, e.g. BCG, are contraindicated in HIV-infected individuals. The considerations underlying these recommendations will be discussed.

Incidence, immune response and effectiveness of vaccinations in HIV-infected individuals
Vaccine Incidence,
morbidity of disease		 Antibody response Indication for vaccination * Protective effectiveness † Strength of recommendation
Influenza –/↑ ↓↓ g(a) u/+ BIII
S. pneumoniae ↑↑ =/↓ g(b) + BII
Hepatitis B ↑ ↓ g + BII
Hepatitis A ↑ ↓ g(r);I + BIII
* indication for vaccination of HIV-infected individuals;
g: recommended;
a: annually;
b: every 3-5 years;
r: in risk groups;
I: when indicated under special circumstances (e.g. travel to endemic areas);
†: protective effectiveness: (some) evidence of protection after vaccination (+); effectiveness unknown (u);
¶: strength of recommendation: modified from Gross, CID 1994

Presenting author: Frank Kroon

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1 Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands.

2002-11-17
PL10-4

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