Recent studies suggest that although children infected with Human Immunodeficiency Virus (HIV) treated with highly active antiretroviral therapy (HAART) are still prone to vaccine-preventable illnesses, revaccination greatly reduces vulnerability and subsequently mortality rate.
William Moss and Catherine Sutcliffe of Johns Hopkins Bloomberg School of Public Health, who authored the study, reviewed previously published data on children’s immune responses to vaccines.
HIV is a retrovirus that replicates in the human genome, leading to a drop in immune system cells and eventual failure of the immune system. Those infected with HIV often die not from the condition itself, but rather from other opportunistic infections against which the body’s immune system is too weak to fight.
HIV is transmitted through bodily fluids, such as blood, semen, vaginal fluid and breast milk. As a result, infected mothers can spread the virus to their children during pregnancy, during childbirth and during breast feeding.
HAART is an approach in which several antiretroviral drugs are combined to achieve the maximal effectiveness against HIV. The goal is to repair the damaged immune system.
Reviews of 38 studies show that due to the effects of HIV, infected children show poorer responses to vaccines compared to healthy children. Furthermore, children with HIV declined in protective immunity much more rapidly than those who are uninfected, and many infected children don’t achieve protective immunity at all.
Comparison of short term (three months) to long term (more than three months) immune responses shows that those who started HAART prior to receiving other vaccinations were able to maintain immunity to vaccine-preventable diseases more. Thus it is crucial to identify the condition and initiate treatment early.
“Recovery of the immune system after treatment with antiretroviral therapy is largely with new immune cells in children and these cells may not maintain immunity to vaccines received before treatment,” Moss wrote in an email to The News-Letter.
Another concern is children in developing countries who are only recently given the chance to receive HAART. They may remain susceptible to vaccine-preventable diseases caused by damage to their immune systems before treatment.
“It would be tragic for a child to be saved by antiretroviral therapy only to die of measles. Revaccination after starting antiretroviral treatment may be the best way to protect these children,” Moss wrote.
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