von Reyn C F, Clements C J, Mann J M
Lancet. 1987 Sep 19;2(8560):669-72. doi: 10.1016/s0140-6736(87)92451-2.
Current experience with the safety and efficacy of vaccines in infected children and adults is reviewed to examine the basis for decisions about routine immunisations of children infected with the human immunodeficiency virus (HIV). No adverse reactions to inactivated vaccines have been noted, but complications with live vaccines have been recorded with both BCG and smallpox. Limited experience with live poliomyelitis and measles vaccines in HIV-infected children has not yet shown any severe complications from these vaccines. Theoretical concerns that immunisation might accelerate the course of HIV infection are not supported by available data. Serological response to most inactivated and live vaccines is reduced in HIV-infected persons, and is related to the degree of immunosuppression present. Preliminary evidence suggests that the severity of some vaccine-preventable diseases is increased in HIV-infected children. This review finds general support for recommendations on immunisation of HIV-infected children that have been developed by the World Health Organisation.
本文回顾了目前关于疫苗在感染儿童和成人中的安全性和有效性的经验，以审视针对感染人类免疫缺陷病毒（HIV）儿童进行常规免疫接种决策的依据。未观察到对灭活疫苗的不良反应，但卡介苗和天花疫苗这两种活疫苗均有并发症记录。在感染HIV的儿童中使用脊髓灰质炎活疫苗和麻疹活疫苗的经验有限，尚未显示出这些疫苗会引发任何严重并发症。现有数据并不支持免疫接种可能加速HIV感染进程这一理论担忧。感染HIV的人群对大多数灭活疫苗和活疫苗的血清学反应降低，且与目前的免疫抑制程度相关。初步证据表明，感染HIV的儿童中一些疫苗可预防疾病的严重程度有所增加。本综述发现，世界卫生组织制定的关于感染HIV儿童免疫接种的建议得到了广泛支持。
