疫苗安全数据链路项目中 HIV 感染成人的疫苗安全性。
Vaccine safety in HIV-infected adults within the Vaccine Safety Datalink Project.
机构信息
Kaiser Permanente Southern California, USA.
Kaiser Permanente Northern California, USA.
出版信息
Vaccine. 2019 May 31;37(25):3296-3302. doi: 10.1016/j.vaccine.2019.04.080. Epub 2019 May 4.
OBJECTIVES
We evaluate safety of routine vaccination among adults infected with human immunodeficiency virus (HIV) in five healthcare organizations in the United States.
METHODS
We conducted a retrospective cohort study of HIV-infected adults who received inactivated influenza vaccines, hepatitis B vaccines, pneumococcal vaccines, or tetanus, diphtheria, and acellular pertussis vaccines between 2002 and 2013. We conducted self-controlled case series analysis to estimate the relative risk (RR) for 11 pre-specified adverse events (AEs) requiring medical attention.
RESULTS
Among 20,417 HIV-infected adults (90.2% male), a total of 137,674 vaccine doses were administered. Based on ICD-9 codes, we detected an increased risk of cellulitis and infection (RR: 1.18, 95% CI: 1.03-1.35) among all patients, and an increased risk of stroke/cerebrovascular diseases among patients with an HIV viral load >10,000 copies/ml (adjusted RR: 3.94, 95% CI: 1.32-11.72). Further analyses on chart confirmed cases of stroke/cerebrovascular diseases indicated no statistically significant increased risk (adjusted RR: 1.72, 95% CI: 0.41-7.24). There was no evidence of increased risk for other AEs following routine vaccination in HIV-infected adults.
CONCLUSIONS
Routinely administered vaccines are generally safe for HIV-infected adults.
目的
我们评估了美国五家医疗机构中感染人类免疫缺陷病毒（HIV）的成年人常规接种疫苗的安全性。
方法
我们对 2002 年至 2013 年间接受过灭活流感疫苗、乙型肝炎疫苗、肺炎球菌疫苗或破伤风、白喉和无细胞百日咳疫苗的 HIV 感染成人进行了回顾性队列研究。我们进行了自身对照病例系列分析，以估计需要医疗关注的 11 种预先指定的不良事件（AE）的相对风险（RR）。
结果
在 20417 名 HIV 感染成人（90.2%为男性）中，共接种了 137674 剂疫苗。根据 ICD-9 编码，我们发现所有患者的蜂窝织炎和感染风险增加（RR：1.18，95%CI：1.03-1.35），HIV 病毒载量>10000 拷贝/ml 的患者中风/脑血管疾病风险增加（调整后的 RR：3.94，95%CI：1.32-11.72）。对图表中中风/脑血管疾病的确诊病例进行进一步分析表明，风险无统计学显著增加（调整后的 RR：1.72，95%CI：0.41-7.24）。在 HIV 感染成人中，常规接种疫苗后没有其他 AE 风险增加的证据。
结论
常规接种的疫苗通常对 HIV 感染成人是安全的。
Zotero 插件