Vaccines in people with HIV infection

Zaal Meher-Homji1, Rachael Purcell2, Jim Buttery2, Michelle Giles1

  1. Department of Infectious Diseases, Alfred Health, VIC
  2. Department of Infectious Diseases, Monash Children’s Hospital, VIC

Last reviewed: July 2019

 Introduction

HIV primarily affects CD4+ T cell numbers and function whilst also impacting other components of the immune system (such as macrophages, B cells and NK cells; summarised in an earlier section). This places people living with HIV at a higher risk of numerous infections, many of which are vaccine preventable. Whilst patients older than 5 years of age with CD4+ T cell counts of <200/mL should not be administered live attenuated vaccines, those with a CD4+ T cell count between 200-350/mL are moderately immunosuppressed and clinical judgement should be used to guide the administration of live vaccines in this cohort. The key considerations this chapter will focus on:

  1. The higher predisposition of people living with HIV to specific vaccine preventable disease
  2. The efficacy/clinical effectiveness of vaccine administration in preventing disease in people living with HIV
  3. The safety of vaccine administration in people living with HIV
  4. Specific considerations in children living with HIV

Recommendations for vaccination of adults with HIV infection are outlined below and summarised in Table 1.