HIV infection and travel: pretravel recommendations and health-related risks.
In the current era of globalization and ease of air travel combined with the increased survival attained since the advent of potent antiretroviral therapy, HIV-infected individuals are traveling to remote and resource-limited areas of the world. Travel-related health risks in a patient with HIV depend on the patient's immune status, destination, travel itinerary, and type of travel. HIV-infected patients with a CD4+ count of 200 cells/mm3 or lower, particularly those who are treatment-naive and newly diagnosed, are at increased risk of complications when traveling to resource-poor settings. These increased risks include those of acquiring gastrointestinal, respiratory, and endemic tropical infectious diseases. Individuals with a CD4+ count higher than 200 cells/mm3 (whether receiving antiretroviral treatment or not) are considered to have limited immune deficiency for the purpose of travel-related recommendations; in general, they may safely receive most recommended and required vaccines. Pretravel consultation before departure is crucial to address strategies to protect against vaccine-preventable diseases (routine, recommended, and required vaccinations); vector-borne diseases, particularly malaria; gastrointestinal infections; and sexually transmitted diseases. HIV-infected travelers who are ill, particularly those with fever, should undergo an immediate medical evaluation to rule out the possibility of a life-threatening infectious disease such as malaria.
Franco-Paredes
Carlos
C
Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA 30303, USA.
Hidron
Alicia
A
Tellez
Ildefonso
I
Lesesne
Jeffrey
J
Del Rio
Carlos
C
D018791:CD4 Lymphocyte Count; D005767:Gastrointestinal Diseases / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D011528:Protozoan Infections / Q000453:epidemiology; D012017:Referral and Consultation; D012141:Respiratory Tract Infections / Q000453:epidemiology; D012307:Risk Factors; D014195:Travel