Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, USA.
Lancet Infect Dis. 2010 Sep;10(9):630-42. doi: 10.1016/S1473-3099(10)70116-X.
No official recommendations have been made on whether children infected with HIV on highly active antiretroviral therapy (HAART) should be revaccinated. We reviewed published work to establish whether these children have protective immunity to vaccine-preventable diseases and to assess short-term and long-term immune responses to vaccination of children given HAART. In general, children on HAART had low levels of immunity to vaccines given before treatment. Most children on HAART, however, responded to revaccination, although immune reconstitution was not sufficient to ensure long-term immunity for some children. These results suggest that children on HAART would benefit from revaccination, but levels of protective immunity might need to be monitored and some children might need additional vaccine doses to maintain protective immunity. Vaccination policies and strategies for children infected with HIV on HAART should be developed in regions of high HIV prevalence to ensure adequate individual and population immunity.
尚未就正在接受高效抗逆转录病毒治疗（HAART）的 HIV 感染儿童是否应重新接种疫苗提出官方建议。我们对已发表的文献进行了综述，以确定这些儿童对疫苗可预防疾病是否具有保护性免疫，并评估给予 HAART 的儿童接种疫苗的短期和长期免疫反应。一般来说，正在接受 HAART 的儿童在治疗前接种疫苗的免疫水平较低。然而，大多数正在接受 HAART 的儿童对重新接种疫苗有反应，尽管免疫重建不足以确保一些儿童的长期免疫。这些结果表明，正在接受 HAART 的儿童将从重新接种疫苗中受益，但需要监测保护免疫水平，一些儿童可能需要额外的疫苗剂量来维持保护性免疫。应在 HIV 高发地区制定针对正在接受 HAART 的 HIV 感染儿童的疫苗接种政策和策略，以确保个体和人群获得足够的免疫。
