[Progressive neurological complications after rabies immunization with Hempt vaccine].
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Since the introduction of antiretroviral therapy (ART), persons living with HIV (PLHIV) are traveling more frequently and international travel has become much safer. Specific concerns include the safety of ART during travel, drug adherence and interactions. The simultaneous administration of ART and antimalarial drugs is a challenge, considering the lack of reliable data. Several travel-related infectious diseases are more frequent and/or more severe in PLHIV. Even with a CD4 count > 400/microl, some PLHIV experience lower immune responses to several vaccines. With avanced immunosuppression, complications following the administration of live vaccines can occur, and most of the responses to vaccine are clearly reduced. The consequences of reduced vaccine immunogenicity on their clinical effectiveness (protection against infection) are unclear.
The increased vulnerability of HIV infected children to infections supports the principle of vaccination. This article summarizes the available data on the practice of vaccination among HIV infected children. Vaccination is, in general, harmless and efficacious in those children. The World Health Organisation (WHO) guidelines are very similar to other recommandations. Nevertheless, the HIV related immunosuppression reduces the vaccination benefits. Moreover, serious complications are possible after BCG-vaccine administration in seriously immunocompromised children. Therefore, children with AIDS should not be given this vaccine. The benefits of anti-poliomyelitis and anti-measles vaccination markedly exceed the low post-vaccination risk reported among these children.
A case of bilateral femoral mycotic aneurysms resulting from bacille Calmette-Guérin vaccine, is reported in a 74-year-old man treated by intravesical immunotherapy. The diagnosis was made after histologic and bacteriologic examinations and biochemical analysis of the acid-fast-baccilli. Treatment consisted of resection and replacement of the femoral arteries, with an expanded polytetrafluoroethylene graft on the left side and a saphenous vein graft on the right side. After surgery the patient was treated with antituberculous chemotherapy for 1 year. The patient was doing well 18 months later.