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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Current experience with the safety and efficacy of vaccines in infected children and adults is reviewed to examine the basis for decisions about routine immunisations of children infected with the human immunodeficiency virus (HIV). No adverse reactions to inactivated vaccines have been noted, but complications with live vaccines have been recorded with both BCG and smallpox. Limited experience with live poliomyelitis and measles vaccines in HIV-infected children has not yet shown any severe complications from these vaccines. Theoretical concerns that immunisation might accelerate the course of HIV infection are not supported by available data. Serological response to most inactivated and live vaccines is reduced in HIV-infected persons, and is related to the degree of immunosuppression present. Preliminary evidence suggests that the severity of some vaccine-preventable diseases is increased in HIV-infected children. This review finds general support for recommendations on immunisation of HIV-infected children that have been developed by the World Health Organisation.
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PMID:Human immunodeficiency virus infection and routine childhood immunisation. 288 50

A polyclonal T-cell receptor complex (TCR) expression defect (as detected with monoclonal antibody WT31) has been found in two children belonging to an otherwise healthy Spanish family. One of the sibs (V, who had been vaccinated with attenuated poliomyelitis virus) showed clinical signs of immunodeficiency with an autoimmune syndrome, but the other (older) sib (D, vaccinated with attenuated rubella, measles, mumps, and poliomyelitis viruses) has been symptomless throughout life. In contrast to both sibs' normal expression of other peripheral leucocyte markers, as measured by flow cytometry (including CD1, CD2, CD4, CD8, and CD16), only about 6% of CD2+ polyclonal T cells expressed surface antigen-specific T-cell receptor (Ti/WT31), and only about 23% weakly expressed surface CD3 determinants. On the remaining CD2+ T cells in each sib the expression of Ti and CD3 was undetectable; the defect in CD3 expression is very likely secondary to the defect in Ti expression. Natural killer (NK) activity was not increased in any of the sibs, ruling out a high content of NK cells among their CD2+ lymphocytes. Functional data indicate that CD3-mediated T-cell activation with anti-CD3 monoclonals and Ti-mediated responses to allogeneic and tetanus toxoid antigens were severely depressed, whereas activation via CD2 was normal in the T lymphocytes of both sibs. Genes encoding for Ti alpha, beta, and gamma chains did not show major alterations by southern blot analysis, and polyclonal beta chain genes rearrangements were detected in both children's T-cell blasts. Family clustering suggests a genetic pathogenesis, but linkage to HLA or other blood group markers has not been found. Sib V had a concomitant autoimmune disease and died after a severe autoimmune haemolytic anaemia, indicating a relationship between the TCR and generation of autoimmune clones. However, the resistance of both individuals to infection and to vaccination with attenuated viruses, and the fact that sib D has been symptomless to date questions the relative importance of the TCR in the immune response against infection, and suggests that alternative T-cell activation pathways and non-specific defence mechanisms (external surfaces--bound and/or cellular) may suffice under certain circumstances.
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PMID:An in vivo functional immune system lacking polyclonal T-cell surface expression of the CD3/Ti(WT31) complex. 296 74

Sera from 31 human immunodeficiency virus (HIV)-infected patients, representing different clinical stages of HIV infection, were assayed for antibodies against measles and mumps viruses by various serological tests and compared to 23 healthy controls. Sera from four patients (two primary, one asymptomatic, and one acquired immunodeficiency syndrome) exhibited a pronounced antibody response to measles as detected by haemagglutination inhibition and radioimmuno-precipitation assay. The RIPA-positive sera showed increased reactivity to all the viral components and in particular to the haemagglutinin (HA) protein of the virus (Fig. 1). Three of these positive patients also showed a similar response to mumps virus. One of the control sera also showed an increase in antibody titre in measles serological tests. The measles antibodies were shown not be anti-HIV antibodies crossreacting with paramyxoviruses. The reactivity to haemagglutinin was still present when using nonglycosylated measles virus antigen grown in the presence of tunicamycin. Whether the accentuated antibody response is due to polyclonal activation mediated by HIV or to reactivation of the viruses remains to be answered.
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PMID:Accentuated antibody response to paramyxoviruses in individuals infected with human immunodeficiency virus. 305 90

The vast majority of HIV infected children in the United States are from inner city families where one or both parents have used intravenous drugs. The bulk of medical opinion indicates that in most cases these children, when they appear well, should receive their routine childhood immunizations. For children who are known to be antibody positive, or where it is known that a family member has HIV related immunodeficiency, IPV should be substituted for OPV. Measles vaccine should be given at 15 months when the child is manifesting no overt symptoms of immunodeficiency. In outbreak periods and in endemic areas measles vaccine should be given regardless of symptomatology. HIV antibody testing prior to the routine immunization of children at risk is not indicated for two reasons. First, the test is not a reliable indication of infection in the child, as passive maternal antibody may persist up to 15 months of age and cannot at this time be distinguished from the child's own antibody. Second, immunization with OPV and MMR have not yet been noted to cause adverse effects in HIV infected individuals and may be efficacious at least in the younger child who may be early in the course of disease and maintain some T and B cell function.
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PMID:Immunization of children infected with HIV: a public health perspective. 316 64

Measles virus particles were visualized in the CSF of two patients with verified subacute sclerosing panencephalitis (SSPE) by using scanning electron microscopy. Immunologic identification of the accumulated particles was performed with monoclonal antibodies, directly conjugated to carboxylated microspheres, specific for different measles virus antigens. The beads were amassed on the filter surface after a 1-hr incubation in the CSF. Spherical particles with a diameter ranging between 150 and 500 nm were detected. Such particles bound specifically to latex beads covered by monoclonal antibodies to measles virus hemagglutinin but not to beads conjugated with monoclonal antibodies specific for nucleoprotein. Adding the two monoclonal antibodies to measles virus hemagglutinin to the CSF agglutinated the virus particles in a dose-dependent way. Further, no particles in the CSF bound to microspheres conjugated with monoclonal antibodies to non-related antigens of Sendai virus, cytomegalovirus, or human immunodeficiency virus. Similarly sized particles were also identified by transmission electron microscopy after concentrating the CSF.
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PMID:Visualization of defective measles virus particles in cerebrospinal fluid in subacute sclerosing panencephalitis. 331 16

Some significant studies reported in the world literature which provide a scientific basis for immunization policy for those children known to be infected with human immunodeficiency virus (HIV) are reviewed. The review covers current experience with immunization of children infected with HIV along with relevant data on immunization of HIV-infected adults and in vitro studies with vaccine antigens and HIV-infected cells. Live vaccines have been contraindicated in children with immunodeficiency diseases because of the potential for disseminated infection with either the viral or bacterial vaccine strain. The assessment of a similar risk in HIV-infected children is complicated by the fact that it is not always known whether HIV-infected children actually are immunodeficient when immunized. Generally, inactivated vaccines are not considered to present a risk to immunodeficient children, but questions have been raised regarding the potential for any immunization to accelerate the course of HIV infection. Consequently, the safety of inactivated vaccines must be considered also. Local reactions and disseminated disease have been describe in HIV-infected individuals. The rate of dissemination of BCG cannot be determined from the available case reports, but they suggest the possibility of an increased risk for this otherwise unusual complication of BCG immunization. Limited data suggest that live measles vaccine doses not cause severe complications in children with HIV infection. Both reports from the US and Europe have failed to document adverse reactions to either live oral or inactivated polio vaccines. No side effects of DPT vaccine were noted in 2 published reports from Europe and the US. Available data on immunogenicity in children and adults show that both primary and secondary antibody responses to immunization are attenuted in the presence of HIV infection. This is particularly the case when immunodeficiency is present. It has been difficult to assess vaccine efficacy in HIV-infected children from industrialized nations due to the relatively low incidence of both vaccine-preventable disease and HIV infection. Only preliminary studies on vaccine efficacy are available from developing nations. This review offers some general support for the recommendations on immunizations of HIV-infected children that were developed by the World Health Organization and the Advisory Committee on Immunization Practices of the US Public Health service. For asymptomatic HIV-infected children, both groups recommend continued administration of standard vaccines. For symptomatic HIV-infected children, both groups recommend continued administration of inactivated vaccines but differ in their recommendations on live vaccines.
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PMID:HIV infection and routine childhood immunization: a review. 332 88

Live virus vaccines can cause serious adverse reactions when administered to immunocompromised patients. Because children infected with human immunodeficiency virus (HIV) may be immunosuppressed, immunization of these children with live virus vaccines is a potential problem. A retrospective survey was conducted by the New York City Department of Health, with consultation from the Centers for Disease Control, to evaluate the frequency of serious adverse events following receipt of live vaccines among children with HIV infection receiving pediatric care in New York City and New Jersey. Outpatient records of 319 children being cared for by 16 participating physicians were reviewed. Of the 319 charts, 221 (69%) contained vaccination histories. Perinatal transmission of HIV infection was suspected for 208 (94%) of the 221 cases and infection via transfusion for the remaining 13 (6%). Of the 221 for whom immunization histories were available, 180 (81%) had received at least one dose of live oral polio vaccine and 70 (32%) had received measles, mumps, and rubella vaccine. There were 120 children for whom a temporal relationship between immunization and onset of symptoms of immunodeficiency could be seen; 46/120 had received at least one dose of oral polio vaccine and 23/45 had received measles, mumps, and rubella vaccine after onset of symptoms. Although follow-up of this population has been limited, there were no reports of serious adverse events such as typical or atypical measles, paralytic poliomyelitis, or aseptic meningitis in the month following vaccination.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Live virus vaccines in human immunodeficiency virus-infected children: a retrospective survey. 339 96

The lymphocytes from the patients with primary immunodeficiency diseases and those under immunosuppressive conditions such as viral infection or administration of antimetabolites were studied by various parameters of T- and B-lymphocytes. T-lymphocyte specific antigen, spontaneous rosette formation with sheep erythrocytes, phytohaemagglutinin response of the lymphocytes and delayed hypersensivity skin reaction were used to assess T-lymphocytes, while complement receptor, surface immunoglobulin, serum immunoglobulin levels and antibody response to antigens were estimated as parameters of B-lymphocytes. 9 of infantile agammaglobulinemia, 8 severe combined immunodeficiency, 5 ataxia telangiectasia, d Di-George syndrome, 11 common variable immunodeficiency, 3 isolated IgA deficiency and 4 cases thymectomized more than 10 years previously were studied and discussed for the results. The peripheral blood lymphocytes, especially T-lymphocytes were reduced in the acute stage of measles infection, while they were increased in infectious mononucleosis caused by EB (Epstein-Barr) virus. Atypical lymphocytes observed in the later disease seemed to originate from mainly T-lymphocytes. Cyclophosphamide had suppressive effect selectively on B-lymphocytes.
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PMID:T- and B-lymphocytes in immunological disorders. 437 62

Viral infections are often associated with immunodeficiency states. Although T lymphocytes have been thought to suppress the host's immune response, the precise cellular basis for this phenomenon remains unclear. Therefore, we characterized peripheral blood mononuclear cells from 9 measles virus-infected children by means of monoclonal antibodies directed against surface antigens expressed on human T lymphocytes and T-cell subsets. In addition, the measles lymphocyte blast transformation response to the T-cell mitogen phytohaemagglutinin (PHA) was evaluated as an index of specific T-cell immunocompetence. During the course of measles, there was a slight reduction in the proportion of total circulating T cells, with a relative decrease in helper-inducer and a parallel increase in suppressor-cytotoxic T lymphocytes. The PHA lymphocyte blastogenic response was found to be defective in children with measles and, interestingly, there was a significant negative correlation between the reduced PHA blast transformation value and the increased proportion of suppressor-cytotoxic cells. The biological implications of these finding with respect to the underlying immunopathology of the measles virus infection are discussed.
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PMID:Immunoregulatory T cells in measles. The relationship between reduced lymphocyte proliferative response to PHA and increased proportion of circulating suppressor-cytotoxic T cells. 623 73

Necrotizing lymphadenitis with Warthin-Finkeldey type giant cells was found in the inguinal lymph nodes of a 14-month-old boy following measles vaccination. Electron microscopy displayed (mostly in the endothelial cells) numerous intracytoplasmic inclusions composed of fine, dense granular and fibrillar material, which (among other structures) are known to occur within various cells in connection with measles paramyxovirus infection. Subsequent investigation disclosed familial immunodeficiency of a predominantly cellular type.
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PMID:Measles lymphadenopathy. 1683 72


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