Updated: Pneumococcal Vaccination for Adults With HIV
Individuals with HIV are at increased risk of serious disease due to Streptococcus pneumoniae, including bacteremia, meningitis, and pneumonia. Pneumococcal vaccination is recommended for all adults with HIV as soon as possible after HIV diagnosis.
Pneumococcal vaccination should not be deferred for patients with CD4 count <200 cells/mm3 and/or detectable viral load; however, the follow-up secondary administration of the PPSV23 vaccine may be deferred until the patient’s CD4 count is >200 cells/mm3 and/or viral load is undetectable.
For patients who have not received a pneumococcal conjugate vaccine or whose vaccination status is unknown: Administer 1 dose of PCV15 or 1 dose of PCV20. If PCV15 is used, follow with 1 dose of PPSV23, with a minimum interval of 8 weeks between the doses.
Some Basics About HIV-Hepatitis B Coinfection:HIV and Hepatitis B share similar routes of transmission. In the United States, a large cohort study of patients with HIV showed that over 10% of men who had sex with men, over 8% of those who injected drugs and over 5% of heterosexual individuals with risk factors tested positive for HBsAg or detectable HBV DNA. Because of the shared transmission routes, there is an increased risk of HIV and HBV co-infection. Despite the advancement of ART, which has a very efficient suppression rate of the HIV and HBV replication, morbidity and mortality rates are still higher in patients with HIV-HBV co-infection. In this episode, Dr. Steven Fine, an infectious disease specialist affiliated with the University of Rochester and Anthony Jordan Health Center, speaks about the management of Hepatitis B in patients with HIV.
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