When is the VZV vaccine indicated in the management of HIV infection in primary care?

Updated: Apr 09, 2019
  • Author: Jason F Okulicz, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Answer

Live vaccine is contraindicated in patients with severe immunosuppression (CD4 count < 200 cells/µL). Consider for HIV-infected, VZV-seronegative persons with CD4 counts of 200 cells/µL or more. If vaccination results in infection with attenuated virus, treat with acyclovir. Susceptible household contacts of susceptible HIV-infected individuals should be vaccinated. Avoid exposure to VZV. If someone without immunity to VZV is exposed to VZV, administer varicella-zoster immune globulin (VZIG) as soon as possible (but within 96 hours).


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