dipsite
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well coming to your query directly
i will vote for option number 5.just because these are childhood respiratory diseases..secondly i never read about these three diseases being common in HIV patients..
what is the answer?
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| vsp99
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1.
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| robin082006
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I go with choice 3.
CD4 is over 500 so we can give vaccine.
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| dipsite
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yope even 1 could be the answer live vaccines are contraindicated in:-
pregnancy
immunosuppressed patients
corticosteroid therapy
etcetera
i am getting only this much at the moment ...
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| priyagrove
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but the answer here is 3 cos the patient may have serious complications due to lack of vaccination as patients CD4 fall below 200. So its the right time to give the vaccine as he is very less likely to develop infection right now.. thats what UW says!
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| dipsite
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see the options are very close in the above question...but still i vote for (5)..buddies have you evere read HIV patient contracting measles,mumps or rubella..i may be wrong..but i want an authentic answer..
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| r_albayunen
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ill go with 1 ... i guess you're right in some way dipsite abput the odds of the viruses on a HIV patient .. but neverthlss you are introducing live attenuated viruses on a inmunosupressed patient .. so .. i just go with 1 
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| fox
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MMR is the only live vaccine indicated in HIV! This is bcos, the effects of natural infection in this setting is very severe. But here it says that he's already immunised at age 15...so I feel there is no neccesity now.
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| webjeee
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what's the answer?
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| CocaCola
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Had problems with this question
According to usmleworld the answer is 3. Let me give you the vaccine...
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| r_albayunen
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i was wrong .. the answer is 3
why? because according to kaplan books an HIV patient could receive any live vaccine if asymptomatic. it has nothing to do with cd4 nor viral load .. is the symptoms. since the pt is asympt .. give him the vaccine.
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| NE
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From cdc.gov guidelines:
HIV patients should receive - MMR ( no if CD4< 200), HBV, Influenza ( not nasal) , S pneumoniae, Td.
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| docnikki
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UW says that MMR should be given to all children and all HIV postive..quest is what if the cild already immunized and later contracts HIV..so should he be revaccinated.
regarding HIV being as C/i to the vaccine i disagree because MMR is the only live vaccine that can be given to HIV postives.
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| doc_clotaire
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3. LEt me give you the vaccine BIG TIME
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| cirus
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MMR vaccine at--> 12-15ms(1st dose), & at 4-6yrs (2nd dose)
I never heared that it is recommended for adults especially if immune compromized(absolute contraindication in children so i guess its still contraindicated in immune compromized adults) so i'll go with 5
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| mjl1717
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doc_clotaire wrote:
3. LEt me give you the vaccine BIG TIME
Agree!! they use to say no live vaccines... but now its based on the T4 count greater then 200 I believe?
good trick question.
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| young_doc
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Any idea on why we have to RE-VACCINATE this patient if he already had it? Don't we develop life-long immunity with the MMR vaccine?
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| cirus
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sorry guys, I got wrong, the ans is 3. this is the CDC recommend for HIV vacc
just follow this link for the recommended vacc
http://www.cdc.gov/mmwr/preview/mmwrhtml/00025228.htm#00000396.htm
Edited by cirus on 07/07/07 - 12:40 PM
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| MAGY17
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3 let me give you the vaccine
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