Wolder Ejlersen Edith, Loft Josefine Amalie, Gelpi Marco, Heidari Safura-Luise, Rezahosseini Omid, Poulsen Johan Runge, Møller Dina Leth, Harboe Zitta Barrella, Benfield Thomas, Nielsen Susanne Dam, Knudsen Andreas Dehlbæk
Department of Infectious Diseases, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark.
Department of Infectious Diseases, Copenhagen University Hospital-Amager and Hvidovre, 2650 Hvidovre, Denmark.
Vaccines (Basel). 2025 Mar 27;13(4):358. doi: 10.3390/vaccines13040358.
BACKGROUND/OBJECTIVES: Influenza and infections are common vaccine-preventable diseases to which people living with HIV (PLWH) may be more susceptible. This study aims to investigate the incidence of confirmed influenza and pneumococcal infections, and to determine the incidence rate (IR) and factors associated with vaccine uptake in a population of virologically suppressed PLWH.
We included 1031 virologically suppressed PLWH from the Copenhagen Comorbidity in HIV Infection (COCOMO) study. Data on infections and vaccinations between 2015 and 2020 were collected from nationwide registries. Incidence rates with 95% confidence intervals (CIs) of confirmed influenza and pneumococcal infections and vaccine uptake were calculated, and predictors of vaccine uptake were explored using logistic regression.
The IR of influenza showed variation from year to year and ranged between 0 (95% CI: 0.0, 7.6) and 18.0 (95% CI: 8.2, 34.1) per 1000 person-years at risk with an overall IR of 8.4 per 1000 person-years at risk (95% CI: 5.4, 12.3). The overall IR of pneumococcal infections was 5.5 per 1000 person-years at risk (95% CI: 3.9, 7.5). Among PLWH, 53.2% were influenza-vaccinated at least once, 72.3% and 22.6% of PLWH were vaccinated at least twice and in all six seasons, respectively, while 31% had at least one pneumococcal vaccine. Previous pneumonia or bronchitis, higher body mass index, use of drugs to treat heart conditions, and longer time with HIV were independently associated with vaccine uptake.
We found high incidences of confirmed influenza and pneumococcal infections in virologically suppressed PLWH, but vaccine uptake was below recommendations, highlighting the need for improved vaccination counseling.
背景/目的：流感和肺炎感染是常见的可通过疫苗预防的疾病，感染人类免疫缺陷病毒（HIV）的人群（PLWH）可能更易感染。本研究旨在调查确诊的流感和肺炎球菌感染的发病率，并确定病毒学抑制的PLWH人群中疫苗接种率及与疫苗接种相关的因素。
我们纳入了来自哥本哈根HIV感染合并症（COCOMO）研究的1031名病毒学抑制的PLWH。2015年至2020年期间的感染和疫苗接种数据从全国登记处收集。计算确诊流感和肺炎球菌感染的发病率及95%置信区间（CI）以及疫苗接种率，并使用逻辑回归探索疫苗接种的预测因素。
流感的发病率逐年变化，每1000人年的风险发病率在0（95%CI：0.0，7.6）至18.0（95%CI：8.2，34.1）之间，总体每1000人年的风险发病率为8.4（95%CI：5.4，12.3）。肺炎球菌感染的总体发病率为每1000人年的风险5.5（95%CI：3.9，7.5）。在PLWH中，53.2%的人至少接种过一次流感疫苗，72.3%和22.6%的PLWH分别至少接种过两次和在所有六个季节都接种过，而31%的人至少接种过一剂肺炎球菌疫苗。既往肺炎或支气管炎、较高的体重指数、使用治疗心脏病的药物以及感染HIV时间较长与疫苗接种独立相关。
我们发现病毒学抑制的PLWH中确诊的流感和肺炎球菌感染发病率较高，但疫苗接种率低于建议水平，突出了改善疫苗接种咨询的必要性。
