Administration of live varicella vaccine to HIV-infected children with current or past significant depression of CD4(+) T cells

J Infect Dis. 2006 Jul 15;194(2):247-55. doi: 10.1086/505149. Epub 2006 Jun 14.


Background: Varicella can be a severe illness in human immunodeficiency virus (HIV)-infected children. The licensed, live attenuated varicella vaccine is safe and immunogenic in HIV-infected children with minimal symptoms and good preservation of CD4(+) T cells (Centers for Disease Control and Prevention immunologic category 1).

Methods: To study the safety and immunogenicity of this vaccine in varicella-zoster virus (VZV)-naive, HIV-infected children with moderate symptoms and/or more pronounced past or current decreases in CD4(+) T cell counts, such children (age, 1-8 years) received 2 doses of vaccine 3 months apart. The children were observed in a structured fashion for adverse events. Blood was tested for VZV antibody and VZV-specific cell-mediated immunity (CMI) at baseline, 8 weeks after each dose, and annually for 3 years. Subjects who had no evidence of immunity 1 year after vaccination received a third dose and were retested.

Results: The vaccine was well tolerated; there were no vaccine-related, serious adverse events. Regardless of immunologic category, at least 79% of HIV-infected vaccine recipients developed VZV-specific antibody and/or CMI 2 months after 2 doses of vaccine, and 83% were responders 1 year after vaccination.

Conclusions: HIV-infected children with a CD4(+) T cell percentage of > or =15% and a CD4(+) T cell count of > or =200 cells/ microL are likely to benefit from receiving varicella vaccine.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-HIV Agents / therapeutic use
  • Antibodies, Viral / blood
  • Antiretroviral Therapy, Highly Active
  • CD4 Lymphocyte Count
  • CD4-Positive T-Lymphocytes / cytology
  • CD4-Positive T-Lymphocytes / immunology*
  • Chickenpox / immunology
  • Chickenpox / prevention & control*
  • Chickenpox Vaccine / administration & dosage
  • Chickenpox Vaccine / adverse effects
  • Chickenpox Vaccine / immunology*
  • Child
  • Child, Preschool
  • Female
  • HIV Infections / immunology*
  • Humans
  • Infant
  • Male


  • Anti-HIV Agents
  • Antibodies, Viral
  • Chickenpox Vaccine