Revaccination May be Necessary for HIV-positive Children

The AIDS Beacon

Revaccination May Be Necessary For HIV+ Children

Revaccination against vaccine-preventable illnesses, such as measles and tetanus, may be necessary in HIV-positive children after starting antiretroviral therapy, according to researchers at the John Hopkins School of Public Health.

In addition, children on antiretroviral therapy may need repeated vaccines or higher dosages to retain their immunity against illnesses over the long-term.

“It’s clear that many HIV-infected children on treatment remain susceptible to vaccine-preventable diseases and would benefit from revaccination,” said Catherine Sutcliffe, lead author of the review, in correspondence with The Beacon.

“Most children receiving treatment responded well to revaccination, although levels of immunity still decreased over time,” she added.

Previous studies have shown that children with HIV often do not respond as effectively to vaccines as children without HIV. This can lead to weaker immunity to vaccine-preventable illnesses or loss of immunity over time.

Starting highly active antiretroviral therapy (HAART) helps restore the immune system and boost immune responses. However, it is not known whether this helps improve immunity from vaccines that were given before starting antiretroviral therapy, or whether children starting HAART instead need to be revaccinated.

To answer this question, the researchers examined previously published studies in which children were vaccinated before starting HAART and their levels of immunity were measured again afterward.

The researchers found that results were mixed, with some children showing improved immunity after starting antiretroviral therapy while others lost their vaccine protection.

For example, one study of children vaccinated with the measles-mumps-rubella (MMR) vaccine found that 40 percent of the children who failed to achieve a vaccine response before starting HAART gained immunity afterward.

However, the same study also found that 53 percent of children who had gained immunity to MMR before HAART lost their immunity after starting antiretroviral therapy.

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