Adult Antiretroviral Guidelines

US DHHS Guidelines with Australian Commentary

Guidelines

Human papilloma virus vaccine

Human papilloma virus (HPV) is an oncovirus responsible for causing genital warts, as well as cervical, vulval, vaginal, penile, anal and oropharyngeal cancers. Whilst many HPV serotypes have been identified, HPV-6 and HPV-11 are responsible for the majority of noncancerous genital warts and HPV16 and HPV-18 are associated with 60% of HPV associated cancers (15). …

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Influenza virus vaccine

Influenza viruses cause a respiratory illness with highly variable severity, and is a common cause of hospitalization, morbidity and mortality in at-risk groups. HIV infection is associated with increased severity of influenza and greater risk of complications, comparable to that of other high-risk groups (22-24). Currently in Australia there are 2 available influenza vaccine types, …

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Measles, mumps, rubella (MMR) vaccine

Measles, mumps and rubella viruses cause a variety of febrile presentations, including conjunctivitis, coryza, maculopapular rash (measles, rubella) and salivary gland swelling (mumps). In HIV-infected patients, measles is associated with a higher mortality, with delayed and atypical presentations (32). The MMR vaccine contains live attenuated virus and is highly immunogenic in healthy subjects, with measles …

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Meningococcal vaccines

Neisseria meningitidis causes meningitis and bacteraemia, with a 5-24 fold increased risk for meningococcal disease among HIV-infected persons across multiple settings associated with a higher mortality (36). Currently in Australia there are increased notifications of disease caused by meningococcal serogroups W and Y across a wide range of age groups. To date there is no …

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Pneumococcal vaccines

Streptococcus pneumoniae causes pneumonia and invasive disease. The rate of invasive pneumococcal disease (IPD) is five to forty-times higher in HIV-infected patients (39, 40), despite the use of antiretroviral therapy (41), with mortality rates ranging from 0-33% (39-41), and up to 57% in those with bacteraemia in the pre-ART era (42).  Risk factors for severe …

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Varicella zoster virus vaccines

Varicella zoster virus (VZV) is a herpes virus that causes primary infection (chickenpox) and reactivation (shingles) after establishing latency within neurons. The rate of VZV seronegativity amongst HIV positive patients in the UK was 1.5%, with those acquiring primary infection more likely to present with severe disease (49). The incidence rate of shingles in HIV …

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Vaccination recommendations for children with HIV infection

Despite the uptake of ART, HIV-infected children have higher risks of vaccine-preventable disease than HIV-uninfected children (54, 55). Immunological impairment may result from viral replication in lymphoid tissue prior to immunological maturation and the development of protective immune responses (56). In general, infants should be immunised according to local immunisation schedules and ‘non-live’ vaccines should …

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VACCINE REFERENCES

Steinhart R, Reingold AL, Taylor F, Anderson G, Wenger JD. Invasive Haemophilus influenzae infections in men with HIV infection. Jama. 1992 Dec 16;268(23):3350-2. PubMed PMID: 1453528. Epub 1992/12/16. eng. von Gottberg A, de Gouveia L, Madhi SA, du Plessis M, Quan V, Soma K, et al. Impact of conjugate Haemophilus influenzae type b (Hib) vaccine …

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References

Steinhart R, Reingold AL, Taylor F, Anderson G, Wenger JD. Invasive Haemophilus influenzae infections in men with HIV infection. Jama. 1992 Dec 16;268(23):3350-2. PubMed PMID: 1453528. Epub 1992/12/16. eng. von Gottberg A, de Gouveia L, Madhi SA, du Plessis M, Quan V, Soma K, et al. Impact of conjugate Haemophilus influenzae type b (Hib) vaccine …

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Adverse reactions to antiretroviral and other drugs in people with HIV infection

Jason A. Trubiano1,2, Elizabeth J.  Phillips3,4 Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia. Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia. Department of Medicine and Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee, USA. Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia. Introduction Adverse drug reactions (ADRs) …

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