Levin Myron J, Gershon Anne A, Weinberg Adriana, Song Lin-Ye, Fentin Terrence, Nowak Barbara
University of Colorado School of Medicine, Denver, Denver, CO 80262, USA.
J Infect Dis. 2006 Jul 15;194(2):247-55. doi: 10.1086/505149. Epub 2006 Jun 14.
Varicella can be a severe illness in human immunodeficiency virus (HIV)-infected children. The licensed, live attenuated varicella vaccine is safe and immunogenic in HIV-infected children with minimal symptoms and good preservation of CD4(+) T cells (Centers for Disease Control and Prevention immunologic category 1).
To study the safety and immunogenicity of this vaccine in varicella-zoster virus (VZV)-naive, HIV-infected children with moderate symptoms and/or more pronounced past or current decreases in CD4(+) T cell counts, such children (age, 1-8 years) received 2 doses of vaccine 3 months apart. The children were observed in a structured fashion for adverse events. Blood was tested for VZV antibody and VZV-specific cell-mediated immunity (CMI) at baseline, 8 weeks after each dose, and annually for 3 years. Subjects who had no evidence of immunity 1 year after vaccination received a third dose and were retested.
The vaccine was well tolerated; there were no vaccine-related, serious adverse events. Regardless of immunologic category, at least 79% of HIV-infected vaccine recipients developed VZV-specific antibody and/or CMI 2 months after 2 doses of vaccine, and 83% were responders 1 year after vaccination.
HIV-infected children with a CD4(+) T cell percentage of > or =15% and a CD4(+) T cell count of > or =200 cells/ microL are likely to benefit from receiving varicella vaccine.
水痘对于感染人类免疫缺陷病毒（HIV）的儿童来说可能是一种严重疾病。已获许可的减毒活水痘疫苗对于症状轻微且CD4(+) T细胞保存良好的HIV感染儿童（美国疾病控制与预防中心免疫分类1类）是安全且具有免疫原性的。
为研究该疫苗在未感染水痘-带状疱疹病毒（VZV）、有中度症状和/或既往或当前CD4(+) T细胞计数有更明显下降的HIV感染儿童中的安全性和免疫原性，此类儿童（年龄1至8岁）每隔3个月接种2剂疫苗。以结构化方式观察儿童的不良事件。在基线、每次接种后8周以及之后3年每年检测血液中的VZV抗体和VZV特异性细胞介导免疫（CMI）。接种疫苗1年后无免疫证据的受试者接种第三剂并重新检测。
疫苗耐受性良好；没有与疫苗相关的严重不良事件。无论免疫分类如何，至少79%的感染HIV的疫苗接种者在接种2剂疫苗后2个月产生了VZV特异性抗体和/或CMI，83%的接种者在接种疫苗1年后有反应。
CD4(+) T细胞百分比≥15%且CD4(+) T细胞计数≥200个/微升的HIV感染儿童接种水痘疫苗可能有益。
