Purpose of review: This review summarizes recent literature addressing immunization in the setting of HIV infection, with a specific focus on emerging evidence that can guide the care of HIV-positive adults.
Recent findings: There are few controlled studies on the clinical efficacy and effectiveness of vaccination in HIV-infected adults receiving highly active antiretroviral therapy (HAART). Published data indicate that HAART restores vaccine immunogenicity, improving the rates and persistence of immune responses, while reducing the risk of vaccine-related adverse events. Despite effective HAART, responses remain often suboptimal relative to HIV-negative individuals, although they improve with larger and more frequent vaccine doses. New vaccines are undergoing trial with promising results, including novel formulations against hepatitis B. Studies are also under way to explore the role of human papilloma virus vaccines for the prevention of anal cancer.
Summary: Protecting HIV-positive patients against vaccine-preventable infections is important now that HAART has restored life expectancy and general well being, and increased the likelihood of HIV-infected patients engaging in exposure-prone activities related to travel, occupation or social interaction. A proactive approach for vaccinating HIV-positive patients also serves an important public health purpose, reducing the pool of susceptible individuals and contributing to the control of prevalent and re-emerging infections.