Measles, mumps, rubella and VZV: importance of serological testing of vaccine-preventable diseases in young adults living with HIV in Germany

Abstract

Measles, mumps, rubella (MMR) and varicella zoster virus (VZV) infection can cause serious diseases and complications in the HIV-positive population. Due to successful vaccination programmes measles, mumps and congenital rubella syndrome has become neglected in Germany. However, recent outbreaks of measles have occurred from import-associated cases. In this cross-sectional study the serostatus for MMR and VZV in 2013 HIV-positive adults from three different university outpatient clinics in Bonn (n = 544), Cologne (n = 995) and Munich (n = 474) was analysed. Sera were tested for MMR- and VZV-specific immunglobulin G antibodies using commercial immunoassays. Seronegativity was found in 3% for measles, 26% for mumps, 11% for rubella and 2% for VZV. Regarding MMR, 35% of patients lacked seropositivity against at least one infectious agent. In multivariable analysis younger age was strongly associated with seronegativity against all four viruses, measles, mumps, rubella (P < 0·001, P < 0·001 and P = 0·001, respectively) and VZV (P = 0·001). In conclusion, there is high need for MMR and VZV vaccination in people living with HIV in Germany born in 1970 or later. Thus, systematic MMR and VZV antibody screening and vaccination should be implemented in the HIV-positive population to prevent serious disease and complications of vaccine-preventable diseases.

Seropositivity, Risks, and Morbidity From Varicella-Zoster Virus Infections in an Adult PWH Cohort From 2000–2020

“…We documented a VZV seropositivity rate of 95% among PWH in Southern Alberta. This is similar to the 97%–98% seropositivity seen in earlier studies of PWH populations and higher than some reports of 78%–94% VZV seropositivity in the general population [ 25–30 ]. As seen in a report in the Dutch adult general population, we also found that immigrant status was predictive of VZV seronegativity [ 29 ].…”

Field Test and Validation of the Multiplier Measles, Mumps, Rubella, and Varicella-Zoster Multiplexed Assay System in the Democratic Republic of the Congo by Using Dried Blood Spots

“…Compared to other measles platforms, the correlation with the Dynex chemiluminescent multiplexed immunoassay fell below an optimal R 2 value of 0.9 with a range between 0.76 and 0.88, but the R 2 observed between the FDA-cleared predicates themselves averages only 0.8 (data not shown). As the Siemens measles kit is commonly used in seroprevalence studies (25–27), additional testing compared the performance of the Dynex chemiluminescent multiplexed limit-of-detection immunoassay to this gold standard, resulting in high correlation of measles results across the two platforms. However, concerns were raised, as the limit of detection and the Siemens manufacturer-recommended cutoff for positivity are close.…”

Prevalence and risk factors of measles seronegativity in a cohort of HIV‐positive subjects: a retrospective study

“…Being born after 1970 was the second risk factor independently associated with measles seronegativity in the present study. Younger age as a risk factor for measles seronegativity in HIV‐infected subjects has been reported in other recent studies in France, Spain and Germany . In Belgium, the measles vaccine has been available since 1974 and MMR vaccination with one dose was introduced to the childhood routine schedule in 1985, while two doses were implemented in 1995 .…”

“…Both the European AIDS Clinical Society and the British HIV Association recommend testing for measles seropositivity at the time of HIV diagnosis and administration of the measles‐mumps‐rubella (MMR) vaccine in the case of seronegativity. Recent studies performed in Europe in HIV‐infected subjects reported rates of seronegativity or lack of seroprotection against measles ranging from 3% to 8% . Although MMR vaccine efficacy is lower in HIV‐infected adults, this live attenuated vaccine is considered to be safe in HIV‐infected subjects with a CD4 count > 200 cells/ μ L .…”