Table 2. Key points and future directions to increase vaccines-induced protection in HIV infected children.

Key points           • HAART, started in the late phases of disease is not able to provide a full recovery of protective memory responses.           • HIV-1 infected children present lower responses to vaccination and more rapid waning of immunity compared with healthy individuals.           • Complete immune reconstitution should be achieved before vaccination in order to obtain a protective and long lasting immune response.           • Currently available serological markers of immune response may not be predictive of protection from vaccine-preventable infections in immune compromised patients.

Future directions      • Provide early HAART to HIV-1 infected infants in order to control viremia and fully reconstitute the immune system prior to vaccination.      • Identify additional and more specific correlates of protective vaccination responses in immune compromised patients.      • Design, through the identification of novel biomarkers predictive of protective vaccination, a personalized vaccination schedule among cohorts of immune compromised patients.