Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Çukurova University, Adana, Turkey.
Department of Infectious Diseases and Clinical Microbiology, University of Medical Sciences, Antalya Training and Research Hospital, Ankara, Turkey.
Turk J Med Sci. 2021 Oct 21;51(5):2311-2317. doi: 10.3906/sag-2102-14.
BACKGROUND/AIM: HIV infection increase the risk of serious disease resulting from common vaccine-preventable infections. Vaccinations are particularly important for HIV infected adults. We aimed to investigate the immunity rates against measles, mumps, rubella, hepatitis A, B, and tetanus in newly diagnosed HIV patients.
Patients who admitted to outpatient clinics of three centers with newly diagnosed HIV infection, between 1 January 2015 and 31 June 2017 were included. Measles, mumps, rubella, varicella zoster virus, hepatitis A, hepatitis B, and tetanus antibody levels were measured by commercial diagnostic kits. Demographical and laboratory data of the patients were recorded.
Five hundred and twenty-three patients were enrolled in the study. Of the patients 87% were male (n = 455) and the mean age was 38 ± 13 years. Serology was available for measles 74.2% (388/523), mumps 73.8% (386/523), rubella 77.8% (407/523), hepatitis A 88.5% (463/523), hepatitis B 97.7% (511/523), tetanus 8.6% (45/523), and VZV 79.9% (418/523). Seropositivity was 82% for measles, 75.6% for mumps, 92.1% for rubella. Of the patients whom all three of the components of the MMR vaccine was tested, 37.7% (127/337) were susceptible at least one and needed the vaccine. Mean age was lower in patients who are nonimmune to measles and mumps (p = 0.008). Younger patients were also nonimmune for hepatitis A, while older patients were nonimmune for hepatitis B.
In our study we found that rates of nonimmunity can increase up to one third of the patients even though there is a national vaccination program. Nonimmune individuals should be detected and vaccinated in line with recent guidelines and response should be monitored because of the possibility of impaired immunity and possible suboptimal response. National campaigns can be launched for adult immunization and physicians should be aware of the importance of adult immunization.
背景/目的：HIV 感染会增加由常见疫苗可预防感染引起的严重疾病的风险。疫苗接种对 HIV 感染者尤为重要。我们旨在调查新诊断的 HIV 患者对麻疹、腮腺炎、风疹、甲型肝炎、乙型肝炎和破伤风的免疫率。
本研究纳入了 2015 年 1 月 1 日至 2017 年 6 月 31 日期间在三个中心的门诊新诊断 HIV 感染的患者。通过商业诊断试剂盒测量麻疹、腮腺炎、风疹、水痘带状疱疹病毒、甲型肝炎、乙型肝炎和破伤风抗体水平。记录患者的人口统计学和实验室数据。
本研究共纳入 523 名患者。其中 87%为男性（n = 455），平均年龄为 38 ± 13 岁。523 名患者中，麻疹血清学检测结果为 74.2%（388/523），腮腺炎为 73.8%（386/523），风疹为 77.8%（407/523），甲型肝炎为 88.5%（463/523），乙型肝炎为 97.7%（511/523），破伤风为 8.6%（45/523），水痘带状疱疹病毒为 79.9%（418/523）。麻疹血清阳性率为 82%，腮腺炎为 75.6%，风疹为 92.1%。在接受三种成分 MMR 疫苗检测的患者中，至少有 1 种免疫成分缺失的患者占 37.7%（127/337），需要接种疫苗。麻疹和腮腺炎未免疫的患者平均年龄较低（p = 0.008）。年龄较小的患者也未免疫甲型肝炎，而年龄较大的患者则未免疫乙型肝炎。
在本研究中，我们发现即使有国家疫苗接种计划，仍有高达三分之一的患者存在非免疫状态。未免疫的个体应按照最新指南进行检测和接种疫苗，并应监测反应，因为可能存在免疫受损和可能的应答不理想的情况。可以开展全国性的成人免疫接种运动，医生应意识到成人免疫接种的重要性。
