Hibberd P L, Rubin R H
Harvard Medical School, Boston, Massachusetts.
Infect Dis Clin North Am. 1990 Mar;4(1):123-42.
An ever-increasing population of immunocompromised individuals, including not only the burgeoning AIDS population but also those patients whose host defenses have been damaged by a wide variety of diseases and their therapies, requires prophylaxis against infectious diseases. Existing vaccines can provide some benefit, but the clinician must always be alert to the fact that vaccine response cannot be assumed and such adjunctive measures as antimicrobial prophylaxis (i.e., amantadine during community-wide influenza outbreaks or penicillin prophylaxis against pneumococcal infection in certain asplenics) and/or intravenous immunoglobulin administration should be considered in some patients. In the future, in addition to developing new vaccines, a major effort should be devoted to the development of immunoadjuvants that would increase the effectiveness of vaccine administration.
免疫功能低下人群的数量不断增加，这不仅包括迅速增长的艾滋病患者群体，还包括那些宿主防御功能因多种疾病及其治疗而受损的患者，他们需要预防感染性疾病。现有的疫苗能提供一定益处，但临床医生必须始终警惕不能想当然地认为患者会对疫苗产生反应，对于某些患者应考虑采取诸如抗菌预防（例如在社区流感暴发期间使用金刚烷胺，或对某些无脾患者使用青霉素预防肺炎球菌感染）和/或静脉注射免疫球蛋白等辅助措施。未来，除了研发新型疫苗外，还应大力致力于研发能提高疫苗接种效果的免疫佐剂。
