Low immunity against vaccine preventable diseases in Turkish HIV cohort

Abstract

Background and aimHIV infection increases the risk of serious disease resulting from common vaccine-preventable infections. Vaccinations are particularly important for HIV infected adults. We aimed to investigate the immunity rates against measles, mumps, rubella, hepatitis A, B and tetanus in newly diagnosed HIV patients. Materials and methodsPatients who admitted to outpatient clinics of three centers with newly diagnosed HIV infection, between 1 January 2015 and 31 June 2017 were included. Measles, mumps, rubella, varicella zoster virus, hepatitis A, hepatitis B and tetanus antibody levels were measured by commercial diagnostic kits. Demographical and laboratory data of the patients were recorded. ResultsFive hundred and twenty-three patients were enrolled in the study. Of the patients 87% were male (n=455) and the mean age was 38±13 years. Serology was available for measles 74.2% (388/523), mumps 73.8% (386/523), rubella 77.8% (407/523), hepatitis A 88.5% (463/523), hepatitis B 97.7% (511/523), tetanus 8.6% (45/523) and VZV 79.9% (418/523). Seropositivity was 82% for measles, 75.6% for mumps, 92.1% for rubella. Of the patients whom all three of the components of the MMR vaccine was tested, 37.7% (127/337) were susceptible at least one and needed the vaccine. Mean age was lower in patients who are non-immune to measles and mumps (p=0.008). Younger patients were also non-immune for hepatitis A, while older patients were non-immune for hepatitis B. ConclusionIn our study we found that rates of non-immunity can increase up to one third of the patients even though there is a national vaccination program. Non-immune individuals should be detected and 2 vaccinated in line with recent guidelines and response should be monitored because of the possibility of impaired immunity and possible suboptimal response. National campaigns can be thrown for adult immunization and physicians should be aware of the importance of adult immunization.

Living with HIV and Getting Vaccinated: A Narrative Review

“…Despite the lack of punctual data on long-term immunogenicity and efficacy, based on severe outcomes of Morbillivirus infection and safety and immunogenicity data from cohort studies and randomized trials, the measles vaccine is recommended by HIV guidelines in PWH with CD4+ count >200 cells/mm 3 and on stable ART [ 102 , 104 ]. Given the low rate of Morbillivirus antibodies among the population [ 122 , 123 , 124 ], far from reaching herd immunity, the pros and cons of recommending vaccination should be considered when evaluating a new patient.…”

Cobertura vacinal de pessoas vivendo com HIV/aids - avaliação do impacto de intervenção educativa para profissionais de saúde

“…Silva et al (2019) destacam o papel das coinfecções como importantes causadores de internações hospitalares e óbitos em PVHIV, no estudo desenvolvido por eles, no nordeste do Brasil, a rubéola esteve entre as coinfecções mais prevalentes, acometendo 1,8% das mulheres que viviam com HIV avaliadas no período. Os autores reforçam que os médicos devem estar cientes da importância da imunização de PVHIV adultas(CANDEVIR et al, 2021). Após o curso mais de 80% discordaram desta afirmação, sendo o aumento na questão estatisticamente significativo.…”