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.
摘要:
根据循证指南,针对麻疹和水痘的疫苗通常推荐给易感HIV阳性患者,只要他们没有严重的免疫功能受损。然而,不建议进行常规筛查以确定血清学状态.我们在巴黎郊区的Avicenne大学医院咨询的HIV感染者(PLWHA)中进行了抗麻疹和抗水痘带状疱疹病毒(VZV)抗体的血清阳性率研究。血清是在2018-2020年收集的,并通过商业免疫测定法对268名患者进行了测试。大多数患者出生在撒哈拉以南非洲(55%),只有23%在欧洲。麻疹和水痘血清阳性分别存在于91.4%和96.2%的患者中。十分之一的患者对至少一种测试疾病具有血清阴性。在单变量分析中,只有年龄较小(p=0.027)与麻疹血清阴性的高风险相关,虽然到达法国的时间较短(p<0.001)和发现HIV的时间较短(p=0.007)与VZV血清阴性的风险较高相关。在多变量分析中没有发现关联。这项研究强调了在PLWHA中缺乏VZV和麻疹血清阴性的特定危险因素,并支持常规筛查的重要性。以提高免疫接种率和降低并发症的风险。