Should infants with HIV infection be immunised?

Infants who are known to be infected with HIV but have no clinical signs of HIV infection (and a normal CD4 count) should be immunised. There is no danger giving them most live vaccines such as polio and measles as their immune system is still functioning normally. However, BCG should not be given.

In contrast, infants with clinical signs of HIV infection should not be given any live virus vaccines, such as BCG, oral polio and measles, but should receive the other routine immunisations. Giving BCG to infants with HIV infection may result in a generalised infection with BCG as their immune system is damaged and not able to control the spread of BCG. Children with AIDS on antiretroviral therapy my benefit from waiting until the CD4 count is normal before giving measles and OPV immunisations.

Infants with immunosuppression due to other causes, such as leukaemia or cytotoxic drugs or large doses of steroids should not be given live vaccines (e.g. polio and measles). They must be protected from exposure to these illnesses.

Infants who are exposed to HIV but are otherwise well should receive routine immunisations.

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