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Response to Childhood Immunizations in HIV-Infected Children Treated with Potent Combination Antiretroviral Therapy A. MELVIN, K. MOHAN, and L. FRENKEL.
Univ. of Washington, Seattle Objective: To determine if treatment of HIV-infected children with potent combination antiretroviral therapy restores the ability to respond to childhood immunizations.
Methods: Antibody titers to tetanus, measles and haemophilus influenzae type B were measured in HIV-infected children treated with combination antiretroviral therapy for at least 6 months. The children were immunized with the vaccines to which they lacked protective antibodies, and the titers were remeasured 4 weeks post-immunization.
Results: Twenty-one children, median age 8 yrs (range 3-14), treated with 3-5 drug regimens including at least one protease inhibitor for a median of 19 months (range 9-36) were included in this investigation. Nineteen of the 21 had plasma RNA levels less than 50 copies/ml. The median CD4% prior to therapy was 26% (range 1-41) and at the time of the investigation 36% (range 22-46). Seventeen of the 21children had protective antibody titers to HIB (median level 252 ng/ml, range 102-5000), 5/19 to tetanus (median level 0.26 IU/ml, range 0.14-0.8) and 4/21 to measles (median 1.7 ISR, range 1.45 - 2.45). To date, fourteen children have been revaccinated with MMR, DtaP and/or HIB as indicated. Nine of ten children seroconverted to measles, 9/11 to tetanus and 3/3 to HIB 4 weeks after the immunizations.
Conclusions: Consideration should be given to readministering childhood immunizations to HIV-infected children successfully treated with combination therapy.
Key Words: children, HAART, immunizations
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