- New global recommendation from the world’s leading experts in meningococcal disease
- Recent evidence shows that people who are HIV positive are at significantly higher risk of meningococcal meningitis
- In a new paper, experts recommend that countries introduce meningitis vaccination programmes for people living with HIV
The Global Meningococcal Initiative (GMI) - an international group of expert scientists, doctors and public health officials - has recommended that people who are human immunodeficiency virus (HIV)-positive should be vaccinated against meningococcal disease (MD).
This global recommendation has been published in the Journal of Infection.
The recommendation is based on recent studies showing an increased risk of MD in individuals who are HIV positive. Results of surveillance data analysis from 2003–2007 in patients of all ages in South Africa, showed that HIV was associated with a higher incidence of MD and higher rates of death from MD.
Other recent studies, including two from the United States from the 2000s, have found a 13-fold and 10-fold greater risk of MD for those with HIV. Patients in these studies were receiving antiretroviral therapy for HIV and a good standard of healthcare.
Immunogenicity studies have shown that two doses of vaccine to protect against MD are required for people who are HIV positive. Individuals with HIV who have been previously vaccinated with one dose of MenACWY should receive a second dose at the earliest opportunity, and continue to receive boosters at the appropriate interval.
Some countries already have recommendations for vaccination with the MenACWY conjugate vaccine, for example the United States. An important issue with such recommendations is, however, the cost of the conjugate vaccine, particularly in low-/middle-income countries with high rates of HIV.