Department of Virology, Royal Free Hampstead NHS Trust, UK.
Curr Opin Infect Dis. 2010 Feb;23(1):32-8. doi: 10.1097/QCO.0b013e328334fec4.
This review summarizes recent literature addressing immunization in the setting of HIV infection, with a specific focus on emerging evidence that can guide the care of HIV-positive adults.
There are few controlled studies on the clinical efficacy and effectiveness of vaccination in HIV-infected adults receiving highly active antiretroviral therapy (HAART). Published data indicate that HAART restores vaccine immunogenicity, improving the rates and persistence of immune responses, while reducing the risk of vaccine-related adverse events. Despite effective HAART, responses remain often suboptimal relative to HIV-negative individuals, although they improve with larger and more frequent vaccine doses. New vaccines are undergoing trial with promising results, including novel formulations against hepatitis B. Studies are also under way to explore the role of human papilloma virus vaccines for the prevention of anal cancer.
Protecting HIV-positive patients against vaccine-preventable infections is important now that HAART has restored life expectancy and general well being, and increased the likelihood of HIV-infected patients engaging in exposure-prone activities related to travel, occupation or social interaction. A proactive approach for vaccinating HIV-positive patients also serves an important public health purpose, reducing the pool of susceptible individuals and contributing to the control of prevalent and re-emerging infections.
本文总结了 HIV 感染背景下免疫接种的最新文献，重点关注新出现的证据，为 HIV 阳性成人的护理提供指导。
在接受高效抗逆转录病毒治疗（HAART）的 HIV 感染者中，关于疫苗接种的临床疗效和效果的对照研究较少。已发表的数据表明，HAART 恢复了疫苗的免疫原性，提高了免疫反应的速度和持久性，同时降低了与疫苗相关的不良事件的风险。尽管进行了有效的 HAART，但与 HIV 阴性个体相比，反应仍然常常不理想，尽管随着更大剂量和更频繁的疫苗接种，反应会有所改善。新疫苗正在进行试验，结果令人鼓舞，包括针对乙型肝炎的新型疫苗。研究也在进行中，以探索人乳头瘤病毒疫苗在预防肛门癌方面的作用。
由于 HAART 已恢复了预期寿命和整体健康状况，并增加了 HIV 感染者从事与旅行、职业或社会互动相关的易感染活动的可能性，保护 HIV 阳性患者免受疫苗可预防的感染非常重要。主动为 HIV 阳性患者接种疫苗也具有重要的公共卫生意义，可以减少易感人群，有助于控制流行和新出现的感染。
