Vaccination and HIV: a review of the literature

People with HIV are at risk for a variety of infections both at home and ab road. Recent studies have reported conflicting data concerning potential ha rmful effects following several inactivated vaccines. Antigenic stimulation by vaccines designed to prevent secondary infections may promote HIV-1 rep lication in certain patients. In HIV-positive subjects, immune response wor sens with progression of the HIV infection. When vaccination is considered, administration of the vaccine must be performed as early as possible in th e course of HIV infection because an HIV-infected patient's response to ina ctivated vaccines is closely related to HIV infection stage. A minority of subjects have a protective antibody response to vaccination. Consequently, specific antibody titters should be measured after vaccination to ensure im mune protection. Immune response is improved by highly active antiretrovira l therapy. Some live attenuated vaccines are considered as beneficial in some specific indications and if administered in the early stages of AIDS. However, vira l load variations following administration of live attenuated vaccines have not been studied yet. (C) 1999 Elsevier Science Ltd. All rights reserved.