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Kolakowska A, Marshall E, Krastinova E, Cros A, Duvivier C, Leroy P, Caby F, Zucman D, Maka A, Salmon D, Chéret A. Insufficient vaccine coverage and vaccine hesitancy in people living with HIV: A prospective study in outpatient clinics in the Paris region. Vaccine 2024; 42:3655-3663. [PMID: 38714445 DOI: 10.1016/j.vaccine.2024.04.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/18/2024] [Accepted: 04/25/2024] [Indexed: 05/09/2024]
Abstract
Vaccine prevention strategies play a crucial role in the management of people living with HIV (PLWH). The aim of this study was to assess vaccination coverage and identify barriers to vaccine uptake in PLWH in the Paris region. A cross-sectional survey was conducted in PLWH in 16 hospitals in the Paris region. The vaccination status, characteristics, opinions, and behaviors of participants were collected using a face-to-face questionnaire and from medical records. A total of 338 PLWH were included (response rate 99.7 %). The median age of participants was 51 years (IQR: 41-58). Vaccination coverage was 77.3 % for hepatitis B (95 % CI: 72.3-81.8 %), 62.7 % for hepatitis A (57.3-67.9 %), 61.2 % for pneumococcal vaccines (55.8-66.5 %), 56.5 % for diphtheria/tetanus/poliomyelitis (DTP) (51.0-61.9 %), 44.7 % for seasonal influenza (39.3-50.1 %), 31.4 % for measles/mumps/rubella (26.4-36.6 %) and 38.5 % for meningococcal vaccine (13.9-68.4 %). The main reason for vaccine reluctance was related to the lack of vaccination proposals/reminders. The overall willingness to get vaccinated was 71.0 % (65.9-75.8 %). In the multivariable analysis, several factors were associated with a higher vaccine uptake; for DTP vaccine: higher education level, having vaccination records, being registered with a general practitioner; for seasonal influenza vaccine: age > 60 years, higher education level, being employed. The overall vaccination coverage was suboptimal. Development of strategies reducing missed opportunity to offer vaccines is needed.
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Affiliation(s)
| | - Esaïe Marshall
- COREVIH Île-de-France Sud, Paris, France; Pierre Louis Institute of Epidemiology and Public Health, University of Paris Sorbonne, INSERM U1136, Paris, France
| | - Evguenia Krastinova
- Pierre Louis Institute of Epidemiology and Public Health, University of Paris Sorbonne, INSERM U1136, Paris, France; Prevention and Community Health, Creteil Hospital, France
| | - Agnès Cros
- COREVIH Île-de-France Sud, Paris, France
| | - Claudine Duvivier
- Paris Cité University, Necker Hospital, AP-HP, Infectious Diseases Department, Necker-Pasteur Infectiology Center, Paris, France; Inserm U1016, CNRS UMR 8104, Université Paris Descartes, Institut Cochin, Paris, France
| | - Pierre Leroy
- Department of Infectious Diseases, Public Health Unit, Groupe Hospitalier Sud Île-de-France, Melun, France
| | - Fabienne Caby
- HIV and STI department, Victor-Dupouy Hospital, Argenteuil, France
| | - David Zucman
- Department of Internal Medicine, Foch Hospital, Suresnes, France
| | - Arthur Maka
- Departement of Infectious Diseases, Bastia Hospital, France
| | - Dominique Salmon
- Department of Infectious Diseases, Hôtel Dieu Hospital, Paris, France; Department of Infectious Diseases, Institut Fournier, Paris, France
| | - Antoine Chéret
- Service de Plateforme de Diagnostic et Thérapeutique pluridisciplinaires, CHU, Guadeloupe; Inserm U1016, CNRS UMR 8104, Université Paris Descartes, Institut Cochin, Paris, France; INSERM-CIC-1424, CHU, Guadeloupe.
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Dauby N, Motet C, Libois A, Martin C. The value of herpes zoster prevention in people aging with HIV: A narrative review. HIV Med 2023; 24:1190-1197. [PMID: 37772682 DOI: 10.1111/hiv.13548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/11/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVE Review the evidence on the incidence and impact of herpes zoster among people living with HIV and the potential impact of recombinant zoster vaccine for people aging with HIV. METHODS Narrative review. RESULTS Although antiretroviral therapy has substantially reduced the risk of herpes zoster among people living with HIV, they remain at an increased risk compared with the general population. Among people aging with HIV, aging per se is now the main risk factor for herpes zoster. Beyond pain, herpes zoster is also associated with a risk of sight-threatening complications in case of trigeminal involvement, disseminated diseases and stroke. Post-herpetic neuralgia is also a potential threat to the quality of life of people aging with HIV. The recombinant zoster vaccine has demonstrated high and sustained efficacy in the prevention of herpes zoster, post-herpetic neuralgia, and other herpes zoster complications in the general population. Immunogenicity data among people living with HIV with high CD4+ T-cell count and controlled viral load are comparable to those among the general population. Real-life effectiveness data indicate high vaccine efficacy among immunocompromised patients other than people living with HIV. High vaccine price, vaccine hesitancy, and limited disease and vaccine awareness represent potential hurdles for high vaccine uptake among people aging with HIV in Europe. CONCLUSIONS Herpes zoster, and its complications, is a vaccine-preventable disease of aging people. Given its impact on quality of life, herpes zoster prevention using recombinant zoster vaccine is a safe strategy to be considered in every person aging with HIV.
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Affiliation(s)
- Nicolas Dauby
- Department of Infectious Diseases, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
- School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium
- U-CRI, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Christian Motet
- Department of Infectious Diseases, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Agnès Libois
- Department of Infectious Diseases, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Charlotte Martin
- Department of Infectious Diseases, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
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Kolakowska A, Brichler S, Delagrèverie H, Marin J, Alloui AC, Cailhol J. Cross sectional survey of Varicella-Zoster virus and measles seropositivity in people living with HIV in a Parisian suburb and a review of current immunization guidelines. Vaccine 2023; 41:3266-3274. [PMID: 37085454 DOI: 10.1016/j.vaccine.2023.03.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/25/2023] [Accepted: 03/23/2023] [Indexed: 04/23/2023]
Abstract
According to evidence-based guidelines, vaccines against measles and varicella are generally recommended to susceptible HIV-positive patients, as long as they are not severely immunocompromised. However, routine screening to determine serologic status is not recommended. We conducted a seroprevalence study of anti-measles and anti-Varicella-Zoster virus (VZV) antibodies in adults living with HIV (PLWHA) consulting at Avicenne University Hospital in a Parisian suburb. Sera were collected in years 2018-2020 and tested by commercial immunoassays in 268 patients. Most of the patients were born in Sub-Saharan Africa (55 %) and only 23 % in Europe. Measles and varicella seropositivity were present respectively in 91.4 % and 96.2 % of patients. One patient in ten was seronegative to at least one of tested diseases. In the univariate analysis, only younger age (p = 0.027) was associated with a higher risk of measles seronegativity, while shorter time since arrival in France (p < 0.001) and shorter time since HIV discovery (p = 0.007) were associated with a higher risk of VZV seronegativity. In multivariate analysis no association was found. This study highlights the absence of specific risk factors for VZV and measles seronegativity in PLWHA and supports the importance of routine screening, in order to increase immunization rates and reduce risk of complications.
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Affiliation(s)
- A Kolakowska
- Service de Maladies Infectieuses et Tropicales, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France.
| | - Ségolène Brichler
- Service de Microbiologie Clinique, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France
| | - Héloise Delagrèverie
- Service de Microbiologie Clinique, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France
| | - Julie Marin
- Université Sorbonne Paris Nord and Université Paris Cité, Inserm, IAME, F-93000 Bobigny, France
| | - Ahmed-Chakib Alloui
- Service de Microbiologie Clinique, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France
| | - Johann Cailhol
- Service de Maladies Infectieuses et Tropicales, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France; Laboratoire Educations et Promotion de la Santé, UR3412, Sorbonne Paris Nord University, Bobigny, France.
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4
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Zou J, Krentz HB, Lang R, Beckthold B, Fonseca K, John Gill M. Sero-positivity, risks, and morbidity from Varicella-Zoster Virus (VZV) infections in an adult PWH (people with HIV) cohort from 2000-2020. Open Forum Infect Dis 2022; 9:ofac395. [PMID: 36004318 PMCID: PMC9394766 DOI: 10.1093/ofid/ofac395] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Varicella-zoster virus (VZV) infection disproportionately affects people with HIV (PWH), primarily presenting as herpes zoster. However, VZV seroprevalence, its association with zoster, and clinical outcomes remain understudied in era of modern antiretroviral therapy (ART). We assessed VZV seroprevalence, rates of VZV illness, and associated health care costs in a large cohort of PWH over 20 years. Methods We performed retrospective chart reviews of patients followed at a regional HIV clinic from January 1, 2000, to December 31, 2020. Serological, immunization, clinical, and costing data were extracted from in-house databases. VZV-related inpatient admissions, emergency department (ED), and urgent care (UC) visits were identified using relevant International Classification of Disease (ICD-10) codes and validated where possible by 2 physicians. Health care utilization costs were adjusted to 2020 Canadian dollars. Results Of 3006 PWH, VZV serology was available for 2628; of these, 2503 (95.2%) were seropositive. Only 39% of known seronegative patients were subsequently immunized for varicella. During 29 768 years of patient follow-up, 38 hospitalizations and 138 ED/UC visits due to VZV infection were identified. Most occurred in VZV-seropositive PWH <50 years of age (82%) who were unimmunized (99.2%) and not on ART (64.8%). Nearly 25% of hospitalizations were due to laboratory-confirmed VZV meningitis/encephalitis. The average admission cost was CDN$33 001; the total measured cost of VZV illness was CDN$1 258 718. Conclusions Despite ART and vaccines for chickenpox and shingles, VZV still caused significant costs and morbidity for PWH, occurring at younger ages and often as encephalitis/meningitis. Supporting ART adherence may reduce VZV illness and hospitalization costs in PWH, and the cost-effectiveness of expanding shingles vaccine use warrants further study.
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Affiliation(s)
- Jason Zou
- Department of Medicine, University of Calgary , Calgary, Alberta , Canada
| | - Hartmut B Krentz
- Department of Medicine, University of Calgary , Calgary, Alberta , Canada
- Southern Alberta Clinic, Alberta Health Services , Calgary, Alberta , Canada
| | - Raynell Lang
- Department of Medicine, University of Calgary , Calgary, Alberta , Canada
- Southern Alberta Clinic, Alberta Health Services , Calgary, Alberta , Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary , Calgary, Alberta Canada
| | - Brenda Beckthold
- Southern Alberta Clinic, Alberta Health Services , Calgary, Alberta , Canada
| | - Kevin Fonseca
- Alberta Precision Labs, ProvLab Calgary , Alberta , Canada
- Department of Microbiology, Immunology &Infectious Diseases, University of Calgary , Calgary, Alberta , Canada
| | - M John Gill
- Department of Medicine, University of Calgary , Calgary, Alberta , Canada
- Southern Alberta Clinic, Alberta Health Services , Calgary, Alberta , Canada
- Department of Microbiology, Immunology &Infectious Diseases, University of Calgary , Calgary, Alberta , Canada
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Kerr C, Kelleher M, Coughlan S, Crowley B, O'Reilly EJ, Bergin C. Changing demographics and immunity to vaccine preventable diseases in people with HIV in Ireland. BMC Infect Dis 2022; 22:582. [PMID: 35768790 PMCID: PMC9245288 DOI: 10.1186/s12879-022-07487-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND HIV infection is associated with an increased risk of morbidity and mortality from vaccine preventable infections. This research describes, in the context of changing patient demographics, the seroprevalence of vaccine preventable viral infections among attendees of the largest centre for HIV positive patients in Ireland. METHODS Baseline serum IgG results for measles, mumps, rubella, varicella zoster virus (VZV) & hepatitis A, as well as hepatitis B sAg, cAb and sAb results, were retrieved for 2534 clinic attendees attending in 2018. Results were available for between 990 and 2363 attendees (39-93%), depending on the test, and were compared with 2013 clinic data. RESULTS There was a 35% increase in attendees in 2018 when compared to 2013. The largest increase was in attendees of South American origin. In 2018, males accounted for 73% of the entire cohort and the HIV acquisition risk for 48% of attendees was MSM. 47% of attendees were originally from Ireland. Among those tested, 33% were susceptible to at least one component of the MMR vaccine. 5% were VZV non-immune (significantly associated with younger age and the acquisition risk status of injection drug use). 21% were hepatitis A non-immune (significantly associated with younger age and being of European or South American origin). 32% were hepatitis B cAb seropositive (significantly associated with older age, injection drug use status and being originally from Africa). 3% demonstrated hepatitis B sAg positivity. 64% had hepatitis B sAb ≥ 10mIU. CONCLUSION In a cohort of attendees to an HIV clinic in a large urban setting, the susceptibility to several common vaccine preventable viral infections, in particular MMR and hepatitis A and B, was high. These results highlight the importance of proactive screening and immunisation to help protect this high risk patient group against vaccine preventable diseases.
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Affiliation(s)
- C Kerr
- Department of Infectious Diseases, St. James's Hospital, Dublin, Ireland. .,Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland.
| | - M Kelleher
- Department of Microbiology, St. James's Hospital, Dublin, Ireland
| | - S Coughlan
- National Virus Reference Laboratory, Belfield, Dublin, Ireland
| | - B Crowley
- Department of Microbiology, St. James's Hospital, Dublin, Ireland
| | - E J O'Reilly
- School of Public Health, University College Cork, Cork, Ireland
| | - C Bergin
- Department of Infectious Diseases, St. James's Hospital, Dublin, Ireland.,Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland
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Muhamad NA, Ab Ghani RM, Abdul Mutalip MH, Muhammad EN, Mohamad Haris H, Mohd Zain R, Abdullah N, Muhammad Azami NA, Abd Jalal N, Ismail N, Mhd Yusuf NA, Othman R, Kamalul Arifin AS, Abdullah MS, Kamaruddin MA, Abu Hassan MR, Aris T, Jamal R. Seroprevalence of hepatitis B virus and hepatitis C virus infection among Malaysian population. Sci Rep 2020; 10:21009. [PMID: 33273475 PMCID: PMC7713078 DOI: 10.1038/s41598-020-77813-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/21/2020] [Indexed: 11/25/2022] Open
Abstract
Malaysia is a country with an intermediate endemicity for hepatitis B. As the country moves toward hepatitis B and C elimination, population-based estimates are necessary to understand the burden of hepatitis B and C for evidence-based policy-making. Hence, this study aims to estimate the prevalence of hepatitis B and C in Malaysia. A total of 1458 participants were randomly selected from The Malaysian Cohort (TMC) aged 35 to 70 years between 2006 and 2012. All blood samples were tested for hepatitis B and C markers including hepatitis B surface antigen (HBsAg), anti-hepatitis B core antibody (anti-HBc), antibodies against hepatitis C virus (anti-HCV). Those reactive for hepatitis C were further tested for HCV RNA genotyping. The sociodemographic characteristics and comorbidities were used to evaluate their associated risk factors. Descriptive analysis and multivariable analysis were done using Stata 14. From the samples tested, 4% were positive for HBsAg (95% CI 2.7-4.7), 20% were positive for anti-HBc (95% CI 17.6-21.9) and 0.3% were positive for anti-HCV (95% CI 0.1-0.7). Two of the five participants who were reactive for anti-HCV had the HCV genotype 1a and 3a. The seroprevalence of HBV and HCV infection in Malaysia is low and intermediate, respectively. This population-based study could facilitate the planning and evaluation of the hepatitis B and C control program in Malaysia.
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Affiliation(s)
- Nor Asiah Muhamad
- Evidence-Based Healthcare Sector, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
- Center for Communicable Diseases Epidemiology Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Rimah Melati Ab Ghani
- Evidence-Based Healthcare Sector, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
- Center for Communicable Diseases Epidemiology Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Mohd Hatta Abdul Mutalip
- Center for Communicable Diseases Epidemiology Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Eida Nurhadzira Muhammad
- Center for Communicable Diseases Epidemiology Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Hasmah Mohamad Haris
- Center for Communicable Diseases Epidemiology Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Rozainanee Mohd Zain
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Noraidatulakma Abdullah
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Azila Muhammad Azami
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nazihah Abd Jalal
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norliza Ismail
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nurul Ain Mhd Yusuf
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Raihannah Othman
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Mohd Shaharom Abdullah
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Arman Kamaruddin
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Tahir Aris
- Center for Communicable Diseases Epidemiology Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, 40170, Shah Alam, Malaysia
| | - Rahman Jamal
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
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7
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Loevinsohn G, Rosman L, Moss WJ. Measles Seroprevalence and Vaccine Responses in Human Immunodeficiency Virus-infected Adolescents and Adults: A Systematic Review. Clin Infect Dis 2020; 69:836-844. [PMID: 30452621 DOI: 10.1093/cid/ciy980] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 11/13/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) recommends an additional dose of measles-containing vaccine (MCV) for human immunodeficiency virus (HIV)-infected children receiving highly active antiretroviral therapy following immune reconstitution. We conducted a systematic review to synthesize available evidence regarding measles seroprevalence and measles vaccine immunogenicity, efficacy, and safety in HIV-infected adolescents and adults to provide the evidence base for recommendations on the need for measles vaccination. METHODS We conducted searches of 8 databases through 26 September 2017. Identified studies were screened independently by 2 reviewers. RESULTS The search identified 30 studies meeting inclusion criteria. Across studies, measles seroprevalence among HIV-infected adolescents and adults was high (median, 92%; 27 studies), with no significant difference compared to HIV-uninfected participants (10 studies). In 6 studies that evaluated the immunogenicity of MCVs among seronegative HIV-infected adults, measles seropositivity at end of follow-up ranged from 0% to 56% (median, 39%). No severe adverse events were reported following measles vaccination in HIV-infected patients. CONCLUSIONS Based on similar measles seroprevalence between HIV-infected and HIV-uninfected adolescents and adults, and the low response to vaccination, these studies do not support the need for an additional dose of MCV in HIV-infected adolescents and adults. These findings support WHO guidelines that measles vaccine be administered to potentially susceptible, asymptomatic HIV-infected adults, and may be considered for those with symptomatic HIV infection if not severely immunosuppressed. Measles-susceptible adolescents and adults, regardless of HIV status, may require targeted vaccination efforts to reach critical vaccination thresholds and achieve regional elimination goals.
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Affiliation(s)
- Gideon Loevinsohn
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
| | - Lori Rosman
- Welch Medical Library, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - William J Moss
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
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8
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Abdullahi A, Fopoussi OM, Torimiro J, Atkins M, Kouanfack C, Geretti AM. Hepatitis B Virus (HBV) Infection and Re-activation During Nucleos(t)ide Reverse Transcriptase Inhibitor-Sparing Antiretroviral Therapy in a High-HBV Endemicity Setting. Open Forum Infect Dis 2018; 5:ofy251. [PMID: 30377627 PMCID: PMC6201150 DOI: 10.1093/ofid/ofy251] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/02/2018] [Indexed: 12/19/2022] Open
Abstract
Background We monitored the evolution of markers of hepatitis B virus (HBV) infection in virologically suppressed HIV-positive patients switching to nucleoside reverse transcriptase inhibitor (NRTI)–sparing antiretroviral therapy within a randomized trial in Cameroon. Methods HBV surface antigen (HBsAg), HBV DNA, and antibodies against surface (anti-HBs), core (total anti-HBc), and e-antigen (anti-HBe) were measured retrospectively in samples collected at study entry and over 48 weeks after NRTI discontinuation. Results Participants (n = 80, 75% females) had a plasma HIV-1 RNA <60 copies/mL, a median CD4 count of 466 cells/mm3, and undetectable HBsAg and HBV DNA at study entry. After NRTI discontinuation, 3/20 (15.0%) anti-HBc-negative patients showed evidence indicative or suggestive of incident HBV infection (163 cases/1000 person-years); 6/60 (10.0%) anti-HBc-positive patients showed evidence indicative or suggestive of HBV reactivation (109 cases/1000 person-years). In one case of reactivation, anti-HBs increased from 14 to >1000 IU/L; sequencing showed HBV genotype A3 and 3 escape mutations in surface (Y100C, K122R, Y161FY). Alongside new-onset detection of HBsAg or HBV DNA, 1 patient experienced acute hepatitis and 6 patients experienced mild or marginal increases in serum transaminase levels. Conclusions Evolving treatment strategies for sub-Saharan Africa must be accompanied by the formulation and implementation of policy to guide appropriate assessment and management of HBV status.
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Affiliation(s)
- Adam Abdullahi
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Olga Mafotsing Fopoussi
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom.,Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
| | - Judith Torimiro
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
| | - Mark Atkins
- Department of Microbiology, Frimley Park Hospital NHS Foundation Trust, Frimley, United Kingdom
| | - Charles Kouanfack
- Day Hospital, Yaoundé Central Hospital, Ministry of Public Health, Yaoundé, Cameroon
| | - Anna Maria Geretti
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
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9
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Geretti AM, Brook G, Cameron C, Chadwick D, French N, Heyderman R, Ho A, Hunter M, Ladhani S, Lawton M, MacMahon E, McSorley J, Pozniak A, Rodger A. British HIV Association Guidelines on the Use of Vaccines in HIV-Positive Adults 2015. HIV Med 2018; 17 Suppl 3:s2-s81. [PMID: 27568789 DOI: 10.1111/hiv.12424] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Anna Maria Geretti
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | | | | | | | | | | | | | | | | | - Mark Lawton
- Royal Liverpool University Hospital, Liverpool, UK
| | - Eithne MacMahon
- Guy's & St Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
| | | | - Anton Pozniak
- Chelsea and Westminster Hospital, NHS Foundation Trust, London, UK
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10
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Chadwick DR, Corbett K, Mann S, Teruzzi B, Horner S. Evaluation of a vaccine passport to improve vaccine coverage in people living with HIV. Int J STD AIDS 2018; 29:1190-1193. [PMID: 29945537 DOI: 10.1177/0956462418779472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
An increased risk of vaccine-preventable infections (VPIs) is seen in people living with HIV (PLWH), and current vaccine coverage and immunity is variable. Vaccine passports have the potential to improve vaccine coverage. The objective was to assess how successful a vaccine passport was in improving vaccine coverage in PLWH. Baseline immunity to VPIs was established in PLWH attending a single HIV clinic and vaccinations required were determined based on the BHIVA Vaccination Guidelines (2015). The passport was completed and the PLWH informed about additional vaccines they should obtain from primary care. After 6-9 months the passport was reviewed including confirmation if vaccines were given. PLWH satisfaction with the system was evaluated by a survey. Seventy-three PLWH provided sufficient data for analysis. At baseline significant proportions of PLWH were not immune/unvaccinated to the main VPIs, especially human papillomavirus, pneumococcus and measles. After the passport was applied immunity improved significantly (56% overall, p < 0.01) for most VPIs; however, full coverage was not achieved. The system was popular with PLWH. The passport was successful in increasing vaccination coverage although full or near-full coverage was not achieved. A more successful service would probably be achieved by commissioning English HIV clinics to provide all vaccines.
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Affiliation(s)
- D R Chadwick
- Centre for Clinical Infection, James Cook University Hospital, Middlesbrough, UK
| | - K Corbett
- Centre for Clinical Infection, James Cook University Hospital, Middlesbrough, UK
| | - S Mann
- Centre for Clinical Infection, James Cook University Hospital, Middlesbrough, UK
| | - B Teruzzi
- Centre for Clinical Infection, James Cook University Hospital, Middlesbrough, UK
| | - S Horner
- Centre for Clinical Infection, James Cook University Hospital, Middlesbrough, UK
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Dauby N, Martin C, Hainaut M, Grammens T, Van den Wijngaert S, Delforge M, De Wit S. Prevalence and risk factors of measles seronegativity in a cohort of HIV-positive subjects: a retrospective study. HIV Med 2018; 19:426-429. [PMID: 29573535 DOI: 10.1111/hiv.12610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Measles infection is a vaccine-preventable disease currently resurging in Europe. HIV-infected subjects are at higher risk of complications following measles infection. We investigated the risk factors associated with being seronegative in a cohort of HIV-infected subjects. METHODS All HIV-infected subjects in our cohort who had a measles serological test performed between December 2005 and May 2017 were retrospectively identified. A measles immunoglobulin G (IgG) titre > 275 mIU/mL was considered protective. Risk factors were analysed using logistic regression. RESULTS Measles serology was available in 273 of 3124 subjects in active follow-up (8.7%). The prevalence of measles seronegativity was 21.6% (59 of 273). In the univariate analysis, being born after 1970 and HIV infection by vertical transmission were both associated with a higher risk of measles seronegativity, while a nadir CD4 T-cell count < 200 cells/μL was associated with a lower risk of measles seronegativity. In the multivariate analysis, only being born after 1970 [odds ratio (OR) 4.9; 95% confidence interval (CI) 1.3-18.7] and vertical transmission (OR 7.7; 95% CI 3.3-18.3) were significantly associated with seronegativity. Among the vertically infected subjects with measles-mumps-rubella (MMR) immunization documentation, the median number of doses of vaccine received before testing was 2 (range 1-3). CONCLUSIONS HIV-infected subjects born after 1970 and vertically infected subjects should be screened for measles seropositivity.
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Affiliation(s)
- N Dauby
- Infectious Diseases Department, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - C Martin
- Infectious Diseases Department, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - M Hainaut
- Pediatrics Department, CHU Saint-Pierre, Brussels, Belgium
| | - T Grammens
- Service of Epidemiology of Infectious Diseases, Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium
| | - S Van den Wijngaert
- Microbiology Department, Laboratoire Hospitalier Universitaire de Bruxelles (LHUB-ULB), Brussels, Belgium
| | - M Delforge
- Infectious Diseases Department, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - S De Wit
- Infectious Diseases Department, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
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12
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Crum-Cianflone NF, Sullivan E. Vaccinations for the HIV-Infected Adult: A Review of the Current Recommendations, Part II. Infect Dis Ther 2017; 6:333-361. [PMID: 28780736 PMCID: PMC5595779 DOI: 10.1007/s40121-017-0165-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Indexed: 12/14/2022] Open
Abstract
Vaccination is a critical component for ensuring the ongoing health HIV-infected adults. Since this group may have reduced immune responses and shorter durations of protection post-vaccination, HIV-specific guidelines have been published. This review article provides a comprehensive discussion of the current guidelines and evidence-based data for vaccinating HIV-infected adults, including data on dosing schedules, immunogenicity studies, and safety. In the current paper, part II of the review, live vaccines, as well as vaccines for travelers and specific occupational groups, will be discussed.
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Affiliation(s)
- Nancy F Crum-Cianflone
- Internal Medicine Department, Scripps Mercy Hospital, San Diego, CA, USA.
- Infectious Disease Division, Scripps Mercy Hospital, San Diego, CA, USA.
- Infectious Disease Division, Naval Medical Center San Diego, San Diego, CA, USA.
| | - Eva Sullivan
- Pharmacy Department, Scripps Mercy Hospital, San Diego, CA, USA
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13
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Storey HL, Singa B, Naulikha J, Horton H, Richardson BA, John-Stewart G, Walson JL. Soil transmitted helminth infections are not associated with compromised antibody responses to previously administered measles and tetanus vaccines among HIV-1 infected, ART naïve Kenyan adults. Parasite Epidemiol Control 2017; 2:13-20. [PMID: 28924616 PMCID: PMC5600515 DOI: 10.1016/j.parepi.2016.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In many regions of sub-Saharan Africa, both HIV and helminth infections are prevalent. HIV-1 (human immunodeficiency virus type 1) and helminth infections can both compromise immune responses in humans. To determine whether the presence of helminth infection or the treatment of helminth infection alters unstimulated vaccine responses among HIV-1 infected individuals, we conducted two nested serologic studies. Blood samples were collected for HIV disease monitoring and vaccine-specific serologic assays, while stool was evaluated by direct microscopy methods. We compared antibody responses to measles and tetanus vaccines in helminth-infected (Ascaris, Trichuris, hookworm and/or Schistosoma mansoni) and uninfected adults 18 years and older (n = 100). We also compared measles and tetanus antibody responses in Ascaris only-infected adults receiving 400 mg albendazole daily for 3 days (n = 16) vs. placebo (n = 19) in a separate study. In both cohorts, over 70% of participants had measles and tetanus responses above the protective threshold. Prevalence of measles responses were similar between helminth-infected and uninfected individuals (82%, 95% CI: 71–93% vs 72%, 95% CI: 59–85%), as well as log10 tetanus antibody levels (− 0.133 IU/mL vs − 0.190 IU/mL, p > 0.05), and did not differ by helminth species. In the Ascaris-infected cohort, changes in measles responses and tetanus responses did not differ between those who received anthelminthic vs. placebo (p > 0.05 for both). In these studies, neither helminth infection, nor deworming, appeared to affect previously administered vaccine responsiveness in HIV-1 infected, ART naïve, adults in Kenya.
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Affiliation(s)
- Helen L. Storey
- Department of Epidemiology, University of Washington, 325 9th Ave, Seattle, WA 98104, USA
- Corresponding author at: Diagnostics Program, PATH, PO Box 900922, Seattle, WA, USA.
| | - Benson Singa
- Kenya Medical Research Institute, Mbagathi Rd, Nairobi, Kenya
| | - Jackie Naulikha
- Kenya Medical Research Institute, Mbagathi Rd, Nairobi, Kenya
| | - Helen Horton
- Seattle Biomedical Research Institute, 307 Westlake Ave N #500, Seattle, WA, USA
| | - Barbra A. Richardson
- Department of Biostatistics, University of Washington, 325 9th Ave, Seattle, WA 98104, USA
| | - Grace John-Stewart
- Department of Epidemiology, University of Washington, 325 9th Ave, Seattle, WA 98104, USA
- Department of Global Health, University of Washington, 325 9th Ave, Seattle, WA 98104, USA
- Department of Allergy and Infectious Diseases, University of Washington, 325 9th Ave, Seattle, WA 98104, USA
| | - Judd L. Walson
- Department of Epidemiology, University of Washington, 325 9th Ave, Seattle, WA 98104, USA
- Department of Global Health, University of Washington, 325 9th Ave, Seattle, WA 98104, USA
- Department of Allergy and Infectious Diseases, University of Washington, 325 9th Ave, Seattle, WA 98104, USA
- Department of Pediatrics, University of Washington, 325 9th Ave, Seattle, WA 98104, USA
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14
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Measles, mumps, rubella and VZV: importance of serological testing of vaccine-preventable diseases in young adults living with HIV in Germany. Epidemiol Infect 2016; 145:236-244. [PMID: 27780480 DOI: 10.1017/s095026881600217x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Measles, mumps, rubella (MMR) and varicella zoster virus (VZV) infection can cause serious diseases and complications in the HIV-positive population. Due to successful vaccination programmes measles, mumps and congenital rubella syndrome has become neglected in Germany. However, recent outbreaks of measles have occurred from import-associated cases. In this cross-sectional study the serostatus for MMR and VZV in 2013 HIV-positive adults from three different university outpatient clinics in Bonn (n = 544), Cologne (n = 995) and Munich (n = 474) was analysed. Sera were tested for MMR- and VZV-specific immunglobulin G antibodies using commercial immunoassays. Seronegativity was found in 3% for measles, 26% for mumps, 11% for rubella and 2% for VZV. Regarding MMR, 35% of patients lacked seropositivity against at least one infectious agent. In multivariable analysis younger age was strongly associated with seronegativity against all four viruses, measles, mumps, rubella (P < 0·001, P < 0·001 and P = 0·001, respectively) and VZV (P = 0·001). In conclusion, there is high need for MMR and VZV vaccination in people living with HIV in Germany born in 1970 or later. Thus, systematic MMR and VZV antibody screening and vaccination should be implemented in the HIV-positive population to prevent serious disease and complications of vaccine-preventable diseases.
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15
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Sadlier C, Carr A, Bergin C. High levels of susceptibility to measles, mumps and rubella (MMR) in HIV-infected individuals in Ireland. J Infect 2016; 73:84-6. [DOI: 10.1016/j.jinf.2016.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 04/14/2016] [Accepted: 04/15/2016] [Indexed: 11/29/2022]
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Grabmeier-Pfistershammer K, Burgmann H, Poeppl W. To the editor Re: HIV care: A missed opportunity for immunization. Vaccine 2016; 34:3633. [DOI: 10.1016/j.vaccine.2016.03.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 03/10/2016] [Indexed: 11/25/2022]
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17
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Seroprevalence of antibodies to measles, mumps, and rubella, and serologic responses after vaccination among human immunodeficiency virus (HIV)-1 infected adults in Northern Thailand. BMC Infect Dis 2016; 16:190. [PMID: 27138005 PMCID: PMC4852403 DOI: 10.1186/s12879-016-1499-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 04/08/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND After the global implementation of national immunization programs for prevention of measles, mumps, and rubella (MMR), the prevalences of protective antibodies to these viruses are high in general population. However, there are limited data among human immunodeficiency virus (HIV)-1 infected individuals. This study aimed to determine the seroprevalence of antibodies to these viruses, and the serologic responses after vaccination among HIV-infected adults in Northern Thailand. METHODS A cross-sectional study was conducted in 500 HIV-infected adults, aged 20-59 years, receiving combination antiretroviral therapy, CD4 cell count ≥200 cells/mm(3), and plasma HIV-1 RNA <50 copies/mL, and 132 HIV-uninfected controls, aged 20-59 years, at Chiang Mai University Hospital during July and August 2011. Prevalences of protective antibodies to these viruses as well as serologic responses after MMR vaccination in those without protective antibody to at least one of the three viruses were compared between groups. RESULTS The prevalences of protective antibodies to measles, mumps, and rubella were 94.2, 55.0, and 84.6 % among HIV-infected adults, and 97.7, 67.5, and 89.4 % among HIV-uninfected controls, respectively. The prevalence of protective antibody to mumps was significantly lower in HIV-infected adults (p-value = 0.010). MMR vaccination was done in 249 HIV-infected and 46 HIV-uninfected controls; at week 8 to 12 after vaccination, the seroprotective rates against measles, mumps, and rubella in HIV-infected adults were 96.4, 70.7, and 98.0 %, respectively, whereas those in HIV-uninfected controls were 100, 87, and 100 %, respectively. No serious adverse effects were observed. CONCLUSIONS In contrast to measles and rubella, the prevalence of protective antibody to mumps was low in both HIV-infected adults and HIV-uninfected controls in northern Thailand. The seroprotective rates after MMR vaccination in both groups were considerably high, except only for mumps. Therefore, MMR vaccination should be considered in all HIV-infected adults receiving antiretroviral therapy with undetectable plasma HIV-1 RNA and CD4 cell count ≥200 cells/mm(3). TRIAL REGISTRATION ClinicalTrials.gov: NCT02724852 , registered on March 31, 2016.
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18
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A history of infection with varicella is strongly predictive of the presence of varicella-zoster virus antibodies in a heterogenous Australian HIV cohort. AIDS 2015; 29:2062-4. [PMID: 26352884 DOI: 10.1097/qad.0000000000000850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Singh HK, Chiu YL, Wilkin T. Measles, Mumps, and Rubella Serostatus and Response to MMR Vaccination Among HIV-Infected Adults. AIDS Patient Care STDS 2015; 29:461-4. [PMID: 26153909 DOI: 10.1089/apc.2015.0050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Harjot Kaur Singh
- Division of Infectious Diseases, Weill Cornell Medical College, New York City, New York
| | - Ya-Lin Chiu
- Everest Clinical Research Service, Inc., Little Falls, New Jersey
| | - Timothy Wilkin
- Department of Medicine, Weill Cornell Medical College, New York City, New York
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20
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Diphtheria, tetanus, poliomyelitis, yellow fever and hepatitis B seroprevalence among HIV1-infected migrants. Results from the ANRS VIHVO vaccine sub-study. Vaccine 2015. [PMID: 26209841 DOI: 10.1016/j.vaccine.2015.07.036] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Few data are available on the seroprotection status of HIV1-infected patients with respect to vaccine-preventable diseases. OBJECTIVE To describe, in a population of HIV1-infected migrants on stable, effective ART therapy, the seroprevalence of diphtheria, poliomyelitis, tetanus, yellow fever antibodies and serostatus for hepatitis B, and to identify factors associated with seroprotection. Vaccine responses against diphtheria, tetanus, poliomyelitis and yellow fever were also studied. METHODS Sub-Saharan African patients participating in the ANRS-VIHVO cohort were enrolled prior to travel to their countries of origin. Serologic analyses were performed in a central laboratory before and after the trip. Univariate and multivariate logistic regression was used to identify factors associated with initial seroprotection. RESULTS 250 patients (99 men and 151 women) were included in the seroprevalence study. Median age was 45 years (IQR 39-52), median CD4 cell count was 440/μL (IQR 336-571), and 237 patients (95%) had undetectable HIV1 viral load. The initial seroprevalence rates were 69.0% (95%CI 63.2-74.7) for diphtheria, 70.7% (95%CI 65.0-76.3) for tetanus, and 85.9% (95%CI 81.6-90.2) for yellow fever. Only 64.4% (95%CI 58.5-70.3) of patients had protective antibody titers against all three poliomyelitis vaccine strains before travel. No serological markers of hepatitis B were found in 18.6% of patients (95%CI 13.7-23.3). Patient declaration of prior vaccination was the only factor consistently associated with initial seroprotection. CONCLUSIONS We found a low prevalence of seroprotection against diphtheria, poliomyelitis, tetanus and hepatitis B. HIV infected migrants living in France and traveling to their native countries need to have their vaccine schedule completed.
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21
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High prevalence of measles seronegativity in adults with HIV infection born in the era of measles vaccination in Northern France. AIDS 2015; 29:241-3. [PMID: 25486416 DOI: 10.1097/qad.0000000000000549] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We investigated measles humoral immunity levels in a cohort of HIV-infected adult patients in France and attempted to identify risk factors for antimeasles antibodies seronegativity. Being born after 1983 [odds ratio (OR) 4.40; 95% confidence interval (95% CI) 1.26-14.09; P = 0.0013] and a nadir CD4⁺ cell count below 100 cells/μl (OR 4.79; 95% CI 1.61-14.82; P = 0.0048) were the two factors independently associated with measles seronegativity. Systematic measles antibody screening should be performed in HIV-infected individuals born in the era of measles vaccination (after 1983 in France).
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22
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Grabmeier-Pfistershammer K, Poeppl W, Herkner H, Touzeau-Roemer V, Huschka E, Rieger A, Burgmann H. High need for MMR vaccination in HIV infected adults in Austria. Vaccine 2014; 32:6020-3. [PMID: 25203449 DOI: 10.1016/j.vaccine.2014.07.114] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 06/26/2014] [Accepted: 07/01/2014] [Indexed: 10/24/2022]
Abstract
Current guidelines recommend screening for HIV infected patients susceptible for vaccine preventable diseases and offering of immunization. However, data regarding the vaccination coverage among this group are largely missing. This study analyzed the serostatus for Measles, Mumps and Rubella of more than 700 HIV infected patients residing in Austria. These patients were representative for the Austrian HIV cohort regarding sex, age, transmission risk and HIV progression markers. 73.6% were on suppressive HAART, mean CD4 cell count was 603c/μl. Seronegativity was 8.4% for Measles, 33.4% for Mumps and 18.8% for Rubella. In total, out of the 713 HIV infected adults analyzed, almost half (47.8%) would require MMR vaccination. In a multivariate analysis migration was significantly associated with seronegativity for Measles (OR 0.5, CI 0.27-0.9) and Mumps (OR 0.57, CI 0.39-0.81). Importantly due to the well preserved immune status of nearly all participants vaccination would be feasible in the majority of the seronegative patients. Thus, a proactive approach would largely reduce the number of patients at risk for vaccine-preventable diseases.
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Affiliation(s)
- K Grabmeier-Pfistershammer
- Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University Vienna, Austria.
| | - W Poeppl
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Austria
| | - H Herkner
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - V Touzeau-Roemer
- Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University Vienna, Austria
| | - Emilia Huschka
- Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University Vienna, Austria
| | - A Rieger
- Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University Vienna, Austria
| | - H Burgmann
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Austria
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Wicker S, Seale H, von Gierke L, Maltezou H. Vaccination of healthcare personnel: spotlight on groups with underlying conditions. Vaccine 2014; 32:4025-31. [PMID: 24912026 DOI: 10.1016/j.vaccine.2014.05.070] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 02/24/2014] [Accepted: 05/27/2014] [Indexed: 11/28/2022]
Abstract
Healthcare personnel (HCP) are at increased risk of acquiring vaccine-preventable diseases (VPDs). Vaccination protects HCP and their patients from nosocomial transmission of VPDs. HCP who have underlying diseases (e.g., immunocompromised, HIV-infected, or those with chronic diseases) and HCP in particular phases of life (e.g., pregnant, elderly) require special consideration in regards the provision of vaccines. On the one hand, live virus vaccines may be contraindicated (e.g., pregnant HCP, immunocompromised HCP), while on the other hand, vaccines not routinely recommended (e.g., pneumococcal) may be indicated (e.g., elderly or immunocompromised HCP). It is not known how many HCP with underlying conditions require special consideration in the healthcare setting. This is an important issue, because the risk for serious morbidity, complications and mortality for HCP with underlying conditions will only increase. The prevention of nosocomial infections requires comprehensive occupational safety programs. The healthcare system must engage HCP and occupational physicians to ensure sufficient vaccination rates as part of an effective nosocomial infection prevention and HCP safety strategy.
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Affiliation(s)
- Sabine Wicker
- Occupational Health Service, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
| | - Holly Seale
- School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney 2052, Australia
| | - Laura von Gierke
- Occupational Health Service, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Helena Maltezou
- Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, 3-5 Agrafon Street, 15123 Athens, Greece
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Keller SC, Yehia BR, Momplaisir FO, Eberhart MG, Share A, Brady KA. Assessing the overall quality of health care in persons living with HIV in an urban environment. AIDS Patient Care STDS 2014; 28:198-205. [PMID: 24654969 DOI: 10.1089/apc.2014.0001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Ensuring high quality primary care for people living with HIV (PLWH) is important. We studied factors associated with meeting Health Resources and Services Administration-identified HIV performance measures, among a population-based sample of 376 PLWH in care at 24 Philadelphia clinics. Quality of care was assessed by a patient-level composite of 15 performance measures, focusing on HIV-specific care, vaccinations, and co-morbid condition screening. Adjusted incidence rate ratios (IRR) demonstrated relationships between patient and clinic factors and the performance measures score. The mean number of measures met was 8.52. Older age groups met more measures than 18- to 29-year-olds (age 40-49: adjusted IRR: 1.19, 95% CI: 1.05-1.35; age ≥50: adjusted IRR: 1.19, 95% CI: 1.03-1.35). Higher CD4 counts were associated with meeting more measures compared to CD4 <200 cells/μL (CD4 350-499 cells/μL: adjusted IRR: 1.14, 95% CI: 1.02-1.28; ≥500 cells/μL: adjusted IRR: 1.12, 95% CI: 1.01-1.26). PLWH attending clinics that provide adherence counseling or case management met more measures (adjusted IRR: 1.12, 95% CI: 1.04-1.21; adjusted IRR: 1.08, 95% CI: 1.02-1.14; respectively) than those attending clinics without these services. Limitations include potentially poor performance measure documentation and equal treatment of measures. Future work should focus on improving compliance with performance measures.
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Affiliation(s)
- Sara C. Keller
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Baligh R. Yehia
- Division of Infectious Diseases, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Florence O. Momplaisir
- Division of Infectious Diseases, Temple University School of Medicine, Philadelphia, Pennsylvania
| | - Michael G. Eberhart
- AIDS Activities Coordinating Office, City of Philadelphia Department of Public Health, Philadelphia, Pennsylvania
| | - Amanda Share
- AIDS Activities Coordinating Office, City of Philadelphia Department of Public Health, Philadelphia, Pennsylvania
| | - Kathleen A. Brady
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
- AIDS Activities Coordinating Office, City of Philadelphia Department of Public Health, Philadelphia, Pennsylvania
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25
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Disseminated vaccine-strain varicella as initial presentation of the acquired immunodeficiency syndrome: A case report and review of the literature. J Clin Virol 2014; 59:63-6. [DOI: 10.1016/j.jcv.2013.10.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 10/18/2013] [Accepted: 10/23/2013] [Indexed: 11/23/2022]
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Predictive factors of herpes zoster HIV-infected patients: another adverse effect of crack cocaine. PLoS One 2013; 8:e80187. [PMID: 24244647 PMCID: PMC3823845 DOI: 10.1371/journal.pone.0080187] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 09/28/2013] [Indexed: 12/01/2022] Open
Abstract
A retrospective cohort study was conducted on 1541 HIV-infected patients to determine variables associated with the incidence of herpes zoster. A single failure Cox model showed that herpes zoster incidence increased following the first 6 months of antiretroviral treatment adjusted hazard ratio (AHR)=5 (95%CI=2.6-9.2), P<0.001; in the >60 years age group AHR=2 (95%CI=1-4), P=0.04; in patients in the top CD8 quartile AHR=2.1 (95%CI=1.3-3.6), P<0.001; and in patients previously reported to use crack cocaine AHR=5.9, (95%CI=1.4-25), P=0.02. Herpes zoster incidence increased in patients with CD4 counts<500 per mm3 and gradually declined since 1992-1996, with AHR=0.3 (95%CI=0.2-0.5), P<0.001 for the 1997-2002 period and AHR=0.24 (95%CI=0.14-0.4), P<0.001 for the 2002-2008 period. Contrary to what has been described elsewhere, there was no specific effect of protease inhibitors on herpes zoster incidence. The present study is the first to suggest that crack cocaine is associated with an increased incidence of herpes zoster. The neurological or immunological effects of crack are discussed.
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27
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Moss WJ, Sutcliffe CG, Halsey NA. Vaccination of human immunodeficiency virus–infected persons. Vaccines (Basel) 2013. [DOI: 10.1016/b978-1-4557-0090-5.00014-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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28
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Llenas-García J, Rubio R, Hernando A, Arrazola P, Pulido F. Do HIV-positive adult immigrants need to be screened for measles–mumps–rubella and varicella zoster virus immunization? AIDS Care 2012; 25:980-9. [DOI: 10.1080/09540121.2012.748881] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Jara Llenas-García
- HIV Unit, Instituto de Investigación Hospital 12 de Octubre (i + 12), Universidad Complutense, Madrid, Spain
| | - Rafael Rubio
- HIV Unit, Instituto de Investigación Hospital 12 de Octubre (i + 12), Universidad Complutense, Madrid, Spain
| | - Asunción Hernando
- Medical Specialties Department, European University of Madrid, Madrid, Spain
| | - Pilar Arrazola
- Preventive Medicine Department, Instituto de Investigación Hospital 12 de Octubre (i + 12), Universidad Complutense, Madrid, Spain
| | - Federico Pulido
- HIV Unit, Instituto de Investigación Hospital 12 de Octubre (i + 12), Universidad Complutense, Madrid, Spain
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[Fingolimod treatment for multiple sclerosis patients. Infectiological aspects and recommendations for vaccinations]. DER NERVENARZT 2012; 83:236-42. [PMID: 21845450 DOI: 10.1007/s00115-011-3360-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Since April 2011 fingolimod (FTY 720, Gilenya®), a new oral treatment, is available for relapsing-remitting multiple sclerosis (MS) in Germany. Adverse effects in pre-marketing clinical controlled multicenter studies have led to specific precautions that have to be followed before initiating treatment. According to the European Union prescribing information fingolimod is not to be used as a first-line treatment, but is licensed as a second-line option or escalating therapy of MS. During treatment physical and neurological examinations as well as regular blood counts should be performed. The immunosuppressive mode of action of fingolimod requires increased awareness of infectious complications. Due to two fatal herpetic infections during the TRANSFORMS trial all patients without a history of chicken pox or without vaccination against varicella zoster virus (VZV) should be tested for antibodies to VZV. Comparably to other immunosuppressive treatment strategies the immune response to vaccines may be hampered during treatment with fingolimod. Thus, on the one hand, vaccination gaps should be closed before initiation of fingolimod treatment and, on the other hand, success of vaccinations during fingolimod therapy may have to be checked by antibody titre assessment.
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Hunter MG, Post JJ. An audit of pneumococcal and hepatitis vaccination in an outpatient HIV clinic. Sex Health 2012; 9:495-6. [DOI: 10.1071/sh11192] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Accepted: 02/28/2012] [Indexed: 11/23/2022]
Abstract
Background HIV-positive adults are at risk of vaccine preventable infections including Streptococcus pneumoniae, hepatitis A virus (HAV) and hepatitis B virus (HBV). Uptake of immunisations in HIV patients is suboptimal despite evidence of efficacy. Methods: An audit was made of the vaccination records in 200 adult HIV-positive regular clinic attendees, with a CD4+ count >200 cells μL–1. Results: Medical records or laboratory data revealed that 10% had been vaccinated against S. pneumoniae; 74% were immune or immunised against HAV; 40% had evidence of natural infection with HBV and 84% of nonimmune patients had been vaccinated. Conclusions: Strategies to improve vaccine uptake are required.
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Fowlkes A, Witte D, Beeler J, Audet S, Garcia P, Curns A, Yang C, Fudzulani R, Broadhead R, Bellini WJ, Cutts F, Helfand RF. Persistence of vaccine-induced measles antibody beyond age 12 months: a comparison of response to one and two doses of Edmonston-Zagreb measles vaccine among HIV-infected and uninfected children in Malawi. J Infect Dis 2011; 204 Suppl 1:S149-57. [PMID: 21666156 DOI: 10.1093/infdis/jir135] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Previously, we demonstrated that measles antibody prevalence was lower at age 12 months among children infected with human immunodeficiency virus (HIV) than uninfected children following measles vaccination (MV) at ages 6 and 9 months. Among HIV-uninfected children, measles antibody prevalence was lower among 1- than 2-dose MV recipients. Here, we report results through age 24 months. METHODS Children born to HIV-infected mothers received MV at 6 and 9 months, and children of HIV-uninfected mothers were randomized to MV at 6 and 9 months or MV at 9 months. We followed children through age 24 months. The child's HIV status was determined and measles immunoglobulin G (IgG) level was measured by enzyme immunoassay (EIA) and by plaque reduction neutralization (PRN) on a subset. RESULTS Among HIV-uninfected children, the difference in measles antibody prevalence at age 12 months between one- and two-dose recipients reported previously by EIA was shown to be smaller by PRN. By age 24 months, 84% and 87% of HIV-uninfected children receiving 1 or 2 doses, respectively, were seroprotected. Only 41% of 22 HIV-infected children were measles seroprotected at age 20 months. DISCUSSION Measles seroprotection persisted through age 24 months among HIV-uninfected children who received 1 or 2 doses of MV. HIV-infected children demonstrated seroprotection through age 12 months, but this was not sustained.
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Affiliation(s)
- Ashley Fowlkes
- Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Girardi E, Scognamiglio P, Sciarrone MR, Loffredo M, Gnesivo C, Noto P, Antonucci G, Capobianchi MR, Ippolito G. High HIV prevalence in male patients with acute hepatitis A in the Rome metropolitan area, Italy 2002-2008. J Hepatol 2011; 54:1102-6. [PMID: 21145799 DOI: 10.1016/j.jhep.2010.09.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Revised: 09/10/2010] [Accepted: 09/21/2010] [Indexed: 01/13/2023]
Abstract
BACKGROUND & AIMS Several outbreaks of hepatitis A affecting homosexual men have been reported in Europe. However, the prevalence of HIV infection in patients affected by hepatitis A has not been extensively studied and hepatitis A is not considered as an indicator disease for routine HIV testing. METHODS We retrospectively analyzed all adult cases of acute hepatitis A, reported by the National Institute of Infectious Disease "L. Spallanzani", Rome-Italy, in 2002-2008. Data on HIV infection were obtained by chart review and cross-linkage with laboratory. Information on exposure to risk factors were collected from the standard questionnaire of the Local Health Unit. RESULTS We analyzed a total of 473 cases of hepatitis A, 368 (77.2%) males that accounted for 75% of all reported cases in Rome, aged 25-64 years (same gender distribution). During the study period, we diagnosed a high proportion of cases among male individuals (78%). Among the male patients, HIV serology was available for 203/368 (55.2%). The overall HIV prevalence was 15.2% (56/368); it was significantly associated with same gender sex and was significantly higher than that observed among patients with hepatitis B (4.0%). CONCLUSIONS We found a high HIV prevalence, associated with same gender sex, among adult male patients diagnosed with hepatitis A in the period 2002-2008, except for 2006. Our data suggest that in a low incidence area for hepatitis A, with a constant high proportion of cases among male individuals, all individuals with acute hepatitis A should be routinely offered an HIV test.
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Affiliation(s)
- Enrico Girardi
- National Institute for Infectious Diseases L. Spallanzani, Rome, Italy.
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Arya SC, Agarwal N. Apropos “Seroprevalence of common vaccine-preventable viral infections in HIV-positive adults”. J Infect 2010; 61:353. [DOI: 10.1016/j.jinf.2010.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Accepted: 07/31/2010] [Indexed: 10/19/2022]
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