John Hopkins Bloomberg HIV infected children receiving highly active anti-retroviral therapy may need revaccination to preserve immunity against preventable diseases. Experts from the Johns Hopkins Bloomberg School of Public Health examine previous data to evaluate these children’s immune responses to the vaccine. They revealed that most children treated with HAART supposedly remained susceptible to vaccine preventable diseases, but responded effectively to revaccination.

Presently there are no official or standard suggestions on revaccination of children receiving HAART which is apparently an essential intervention in lowering morbidity and mortality among HIV infected children. The World Health organization recommends giving regular childhood vaccines to children suffering from HIV, however they do not suggest revaccination.

“Most children on HAART responded to revaccination, although immune reconstitution was not sufficient to ensure long-term immunity for some children,” elucidated William Moss, MD, MPH, senior author of the review and an associate professor with the Bloomberg School’s Department of Epidemiology.

He further adds, “Because of the progressive effects of HIV infection on the ability of the immune system to mount an effective response, many infected children have poorer responses to vaccines than do uninfected children. In addition, fewer children infected with HIV achieve protective immunity, and those who do might experience greater and more rapid waning of immunity. These results suggest that children on HAART would benefit from revaccination, but levels of protective immunity might need to be monitored and some children may need additional vaccine doses to maintain protective immunity.”

Scientists examined around 38 published analyses to evaluate if children infected with HIV on HAART have protective immunity to vaccine-preventable diseases. They also assessed short-term and long-term immune responses to vaccination of children given HAART.

“Continued efforts are needed to identify and treat HIV-infected children at younger ages and at earlier stages of disease,” said Catherine Sutcliffe, PhD, lead author of the review and a research associate with the Bloomberg School’s Department of Epidemiology.

Catherine further shares, “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. Without such recommendations, as treatment programs scale up and more children receive HAART and live into adolescence and adulthood, a larger proportion of these children could be susceptible to childhood diseases.”

Experts revealed that short-term duration was identified as less than or equal to 3 months and long-term was defined as greater than 3 months. They revealed that starting HAART in infancy before receipt of routine childhood vaccines may preserve immunity to vaccine-preventable diseases.

These findings were published in the September issue of the Lancet Infectious Diseases.