Grabmeier-Pfistershammer K, Poeppl W, Herkner H, Touzeau-Roemer V, Huschka Emilia, Rieger A, Burgmann H
Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University Vienna, Austria.
Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Austria.
Vaccine. 2014 Oct 14;32(45):6020-3. doi: 10.1016/j.vaccine.2014.07.114. Epub 2014 Sep 6.
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.
现行指南建议对易感染疫苗可预防疾病的HIV感染患者进行筛查并提供免疫接种。然而，关于该群体疫苗接种覆盖率的数据大多缺失。本研究分析了居住在奥地利的700多名HIV感染患者的麻疹、腮腺炎和风疹血清学状态。这些患者在性别、年龄、传播风险和HIV进展标志物方面代表了奥地利HIV队列。73.6%的患者接受了抑制性高效抗逆转录病毒治疗（HAART），平均CD4细胞计数为603个/μl。麻疹血清阴性率为8.4%，腮腺炎为33.4%，风疹为18.8%。在总共713名接受分析的HIV感染成年人中，近一半（47.8%）需要接种MMR疫苗。在多变量分析中，移民与麻疹（比值比0.5，可信区间0.27 - 0.9）和腮腺炎（比值比0.57，可信区间0.39 - 0.81）的血清阴性显著相关。重要的是，由于几乎所有参与者的免疫状态良好，大多数血清阴性患者都可以接种疫苗。因此，采取积极主动的方法将大大减少易患疫苗可预防疾病的患者数量。
