Do HIV-positive adult immigrants need to be screened for measles–mumps–rubella and varicella zoster virus immunization?

Abstract

A systematic screening for measles, mumps, rubella (MMR) and varicella zoster virus (VZV) in HIV-positive adult immigrants in Spain was evaluated, and factors associated with MMR and VZV vaccines' indication were studied. Every HIV-positive immigrant was tested for VZV and MMR-IgG. MMR vaccine was indicated to patients with lymphocytes CD4+ >200 cells/mm³ and a negative measles-IgG, a negative mumps-IgG and/or a negative rubella-IgG. VZV vaccine was indicated to every VZV-IgG negative patient with CD4+ >400 cells/mm³. In total, 289 patients were screened; seroprevalence was 95.2%, 92.2%, 70.3% and 89.3% for VZV, measles, mumps and rubella IgG, respectively. Having a negative VZV-IgG was statistically associated with coming from sub-Saharan Africa (prevalence ratio [PR]: 6.52; 95% CI: 1.71-24.84; p=0.006), while having secondary education was a protective factor (PR: 0.25; 95% CI: 0.07-0.97; p=0.045). Fourteen patients (4.8%) had indication of VZV vaccine; vaccination was feasible in 21.4% of them at first visit. Eighty-one patients (29.7%) had indication of MMR vaccine, most of them due to mumps-IgG negative (53.1%) or rubella-IgG negative (24.7%). Age < 30 years at first visit was the only factor statistically associated with MMR vaccine indication (PR: 1.47; 95% CI: 1.02-2.11; p=0.04). According to CD4+ cell counts, vaccination was feasible in 71.6% of patients at first visit. In conclusion, more than a third of HIV-infected immigrant patients are susceptible to at least one easily preventable infectious disease. Especial attention should be given to immigrant women of childbearing age.

High prevalence of measles seronegativity in adults with HIV infection born in the era of measles vaccination in Northern France

“…In patients born outside of France (36.2%), the prevalence of measles seronegativity did not differ from that of patients born in France. This result is consistent with the prevalence of measles seronegativity (4.9%) observed in HIV adult immigrants in Spain in 2008-2009 [5]. In line with our study, age less than 30 years was a significant risk factor for measles seronegativity (11% versus 2.5%; P ¼ 0.01) [5].…”

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

“…Thus, the likelihood of HIV-positive individuals being in contact with vaccine-preventable infections in occupational, social and travel exposures has increased substantially. At the same time, studies from other countries have demonstrated low frequency of seropositivity against MMR or VZV in HIV-positive patients, especially in young adults [1,[8][9][10][11][12][13]. The guidelines from the European AIDS Clinical Society (EACS) therefore recommend a proactive approach towards screening and vaccination in HIV-positive individuals [14].…”

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 .…”