Raus I. Improvement of vaccination regimens for HIV-infected children receiving antiretroviral therapy

The dissertation is devoted to the actual problem of pediatrics - improvement of immune protection against vaccine-preventable infections in HIV-infected children on the basis of studying the features of functioning of the immune system and determining the factors that influence the formation immunity to vaccine. The vaccine status of children with HIV infection was conducted for the first time in Ukraine, significant reduction in the coverage of their immunization was found. It has been established that in Ukraine the level of vaccine immunity in children with HIV infection is reduced both against viral (measles, mumps, hepatitis B) and bacterial (diphtheria, tetanus, pertussis, H. influenzae type b) vaccine-preventable infections. The factors influencing the level of immune protection against vaccine- preventable viral and bacterial infectious diseases in children with HIV were determined: the degree of immunosuppression at the beginning of antiretroviral therapy, the age of onset of treatment with ARV drugs, vaccination after the onset of ART. Based on a study of children with perinatal HIV infection, the study of humoral immunity and the state of immune memory of the B-lymphocyte noted its insufficient recovery against ARV therapy and imbalance of B-lymphocytes, which may explain the impact on the formation and duration of immune responce after vaccination. Effectiveness and safety of vaccines in HIV-infected children on ARV therapy have been scientifically substantiated and proven. Immunoprophylaxis algorithm that enables safe and individualized vaccination of children with HIV was substantiated and proven. Key words: HIV infection, vaccination, children, vaccine immunity, specific antibodies, antiretroviral therapy