Varicella vaccination in HIV-1-infected children after immune reconstitution

AIDS. 2006 Nov 28;20(18):2321-9. doi: 10.1097/QAD.0b013e3280113f29.


Background: HIV-1-infected children have an increased risk of severe chickenpox. However, vaccination is not recommended in severely immunocompromised children.

Objective: Can the live-attenuated varicella zoster virus (VZV) Oka strain be safely and effectively given to HIV-1-infected children despite previously low CD4 T-cell counts?

Methods: VZV vaccine was administered twice to 15 VZV-seronegative HIV-1-infected children when total lymphocyte counts were greater than 700 lymphocytes/microl, and six HIV-negative VZV-seronegative siblings. Weekly clinical follow-up and sampling were performed.

Results: None of the children developed any clinical symptom or serious adverse reaction after immunization. Only nine (60%) of the HIV-1-infected children had VZV-specific antibodies after two immunizations, whereas 100% of the siblings seroconverted. Age at baseline was negatively correlated with the VZV IgG titre at 6 weeks after the second vaccination in HIV-1-infected children. VZV-specific antibody titres after two immunizations were at a similar level to those found after wild-type infection in non-vaccinated HIV-1-infected patients, but significantly lower than in HIV-negative siblings. Importantly, VZV-specific T-cell responses increased after vaccination and were comparable in both groups over time. Documented wild-type VZV contact in three vaccinated patients did not result in breakthrough infections.

Conclusion: VZV vaccination of previously immunocompromised HIV-1-infected children was safe. Vaccination induced specific immune responses in some of the vaccinated HIV-1-infected children, suggesting that previously immunocompromised individuals are protected against severe forms of varicella.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Viral / analysis
  • Antibodies, Viral / biosynthesis
  • Antibody Specificity / immunology
  • Chickenpox / immunology*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • HIV Infections / immunology*
  • HIV-1 / immunology*
  • Herpesvirus 3, Human / immunology
  • Humans
  • Immunoglobulin G / analysis
  • Lymphocyte Count
  • Male
  • Risk Factors
  • Siblings
  • T-Lymphocytes / immunology
  • Vaccines, Attenuated / therapeutic use
  • Viral Vaccines / adverse effects
  • Viral Vaccines / therapeutic use*


  • Antibodies, Viral
  • Immunoglobulin G
  • Vaccines, Attenuated
  • Viral Vaccines