Yellow fever vaccination in HIV-infected patients

摘要

Millions of HIV-infected individuals are at risk to yellow fever (YF), a severe hemorrhagic disease, which is endemic in tropical areas of Africa and Latin America. The 17D YF vaccine (17DV) is the most effective preventive strategy. Increased vaccine coverage campaigns guided by the WHO, try to prevent outbreaks in YF-endemic countries, including HIV-endemic areas. Data regarding safety and immunogenicity of I7DV in HIV-infected individuals are limited to small studies, mainly in travelers with CD4 cell counts above 200 cells/mm3, demonstrating a reduced immune response and good tolerability. However, rare serious adverse events cannot be excluded. According to current recommendations, I7DV should only be given to asymptomatic HIV-infected individuals with a CD4 cell count above 200 cell/mm3. Data concerning I7DV in HIV-infected individuals living in YF-endemic areas are missing, making mass immunization campaigns against YF very challenging. There is a special need for further studies to investigate the safety and efficacy of I7DV in HIV-infected individuals.