Ho Yeh Li, Enohata Thatiana, Lopes Marta Heloisa, De Sousa Dos Santos Sigrid
Service of Extension for the Treatment of HIV/AIDS Patients "Casada AIDS," Hospital das Clínicas, University of São Paulo School of Medicine, Brazil.
AIDS Patient Care STDS. 2008 Jan;22(1):65-70. doi: 10.1089/apc.2007.0059.
HIV-infected patients are at risk for vaccine-preventable infections. The Brazilian National Immunization Program provided recommendations for this population. However, the vaccine coverage reached by this program is unknown. This study aimed at evaluating the vaccine coverage of HIV-infected adults followed at Hospital das Clínicas, University of São Paulo School of Medicine. Data were collected on age, gender, mode of HIV transmission, Centers for Disease Classification 1993 classification (CDC/93), antiretrovirals, CD4 count, HIV viral load, and immunization charts, from April 2003 to August 2004. We interviewed 144 randomly selected patients, 74% male; mean age, 39.95 years; CDC classification: A, 40.6%; B, 19.6%; and C, 39.9%. Most of patients were undergoing highly active antiretroviral therapy (HAART; 86.8%). Mean CD4 count 442.6 cells/mm3. Viral load less than 400 copies per milliliter in 59.4% of patients. Only 36.1% of patients were adequately immunized for diphtheria/tetanus, 54.9% for pneumococcus, 24.3% for flu, and 76.9% for hepatitis B. In relation to live attenuated vaccines, 5 patients received measles, mumps, and rubella vaccine and 7 patients yellow fever vaccine. Two patients were vaccinated against yellow fever despite CD4 less than 200 cell/mm3. We verified poor vaccine coverage in HIV-infected patients. Vaccination campaigns and incorporation of vaccine rooms in sexually transmitted disease (STD)/AIDS clinics could improve this situation.
感染艾滋病毒的患者有感染疫苗可预防疾病的风险。巴西国家免疫规划为这一人群提供了建议。然而，该规划所达到的疫苗接种覆盖率尚不清楚。本研究旨在评估圣保罗大学医学院临床医院所随访的成年艾滋病毒感染者的疫苗接种覆盖率。在2003年4月至2004年8月期间，收集了有关年龄、性别、艾滋病毒传播方式、1993年疾病分类中心分类（CDC/93）、抗逆转录病毒药物、CD4细胞计数、艾滋病毒病毒载量以及免疫接种图表的数据。我们对144名随机选取的患者进行了访谈，其中男性占74%；平均年龄为39.95岁；CDC分类：A类占40.6%；B类占19.6%；C类占39.9%。大多数患者正在接受高效抗逆转录病毒治疗（HAART；86.8%）。平均CD4细胞计数为442.6个/立方毫米。59.4%的患者病毒载量低于每毫升400拷贝。仅36.1%的患者对白喉/破伤风进行了充分免疫接种，54.9%的患者对肺炎球菌进行了免疫接种，24.3%的患者对流感进行了免疫接种，76.9%的患者对乙肝进行了免疫接种。关于减毒活疫苗，5名患者接种了麻疹、腮腺炎和风疹疫苗，7名患者接种了黄热病疫苗。2名患者尽管CD4细胞计数低于200个/立方毫米仍接种了黄热病疫苗。我们证实艾滋病毒感染者的疫苗接种覆盖率较低。疫苗接种运动以及在性传播疾病（STD）/艾滋病诊所设立疫苗接种室可能会改善这种情况。
