PNEUMOCOCCAL VACCINATION OF HIV-INFECTED INDIVIDUALS - SAFETY AND EFFICACY

The finding of an increased risk of HIV-infected individuals for contr acting pneumococcal diseases has led to the recommendation of antipneu mococcal vaccination of HIV-infected individuals. However, due to repo rts of increased viral replication following immune stimulation, the v accination policy has been called into question. The literature on cha nges in viral load and CD4 T cells following vaccination and the studi es on the clinical efficacy of antipneumococcal vaccination is evaluat ed. It is concluded that the prevailing data do not lend support to th e concern of a lasting effect of vaccination on viral load. Data on th e clinical efficacy and serological responses of vaccination are too s canty to support the recommendation of antipneumococcal vaccination to HIV-infected individuals. In addition to the issue of clinical effica cy; many questions remain to be addressed; for example, the protective antibody level, optimal timing and vaccination regimen are yet to be determined.