Prevention of Infectious Diseases due to Immunosuppression and Vaccinations in Asian Patients with Inflammatory Bowel Disease

Abstract

Background: Inflammatory bowel disease (IBD) patients with immunocompromise have a high risk of developing complications related to viral infections. Western countries were the first to formulate vaccine guideline. Asian countries developed their national and international vaccine guidelines a little later in order to reduce the risk of mortality from viral infections. However, no studies to date have examined the differences in vaccinations that prevail among Asian countries. Summary: This review summarizes the vaccination status and schedules in various Asian countries for immunocompromised IBD patients. Vaccination rates, regardless of the specific vaccine, were high in Japan, South Korea, and China and low in India and the Philippines. Vaccine schedules differed by country, and outbreaks of measles and rubella were seen due to low vaccination rates in Southeast Asia and South Asia. Live vaccines cannot be administered during immunosuppressive treatment. Infection with measles, mumps, and varicella during immunosuppressive therapy carries a high risk of mortality, and thus confirmation of immunization status is recommended as soon as IBD is diagnosed and, when possible, live vaccines should be administered before the initiation of immunosuppressive treatment. In patients seronegative for hepatitis B, administration of the hepatitis B vaccine is also recommended. Key Messages: Physicians, while considering severity of outbreaks, should understand the differences in vaccination status that exist among the various Asian countries and regions.

The incidence rate of herpes zoster in inflammatory bowel disease

“…Inflammatory bowel disease itself can cause immune dysfunction and further places these patients at higher risk of developing bacterial, viral, or fungal infections [11,15] . In addition, drug-induced immunosuppression related to the treatments of inflammatory bowel disease also places these patients at higher risk of developing bacterial, viral, or fungal infections [11–15] …”

“…The association between inflammatory bowel disease and subsequent comorbidities has been investigated in previous meta-analysis, including depression, suicide, and others [8–10] . An immunocompromised status related to inflammatory bowel disease itself or caused by immunosuppressive/immunomodulatory therapy has placed these patients more susceptible to bacterial, viral, or fungal infections [11–15] . To date, existing epidemiological studies have shown that patients with inflammatory bowel disease are at higher risk of developing herpes zoster, but the incidence rates of herpes zoster in patients with inflammatory bowel disease varied from study to study, ranging from 7.54 per 1000 person-years to 18.34 per 1000 person-years [16–22] .…”

“…[8][9][10] An immunocompromised status related to inflammatory bowel disease itself or caused by immunosuppressive/immunomodulatory therapy has placed these patients more susceptible to bacterial, viral, or fungal infections. [11][12][13][14][15] To date, existing epidemiological studies have shown that patients with inflammatory bowel disease are at higher risk of developing herpes zoster, but the incidence rates of herpes zoster in patients with inflammatory bowel disease varied from study to study, ranging from 7.54 per 1000 person-years to 18.34 per 1000 personyears. [16][17][18][19][20][21][22] Given the great variety of the incidence rate of herpes zoster, if more evidence can be found, decision-making on vaccination against herpes zoster will be definite.…”

Current Status of Opportunistic Infection in Inflammatory Bowel Disease Patients in Asia: A Questionnaire-Based Multicenter Study

“…Several studies have suggested that IBD patients treated with immunosuppressive drugs are prone to viral reactivation and infections from bacteria, fungi, or parasites. [5][6][7][8] These infections make the disease pattern of IBD difficult to recognize and to treat. Due to opportunistic infection, IBD patients face longer hospital stay, higher colectomy rate, and higher mortality risk.…”

Post‐marketing analysis for biosimilar CT‐P13 in inflammatory bowel disease compared with external data of originator infliximab in Japan

“… 10 The anti‐TNF therapy is also known to reactivate latent tuberculosis and hepatitis B virus infections, 11 and the prevalence of tuberculosis infection and viral hepatitis in the Asia‐Pacific region is much higher than in Western countries. 12 , 13 , 14 Higher risk of tuberculosis associated with originator IFX in Asian countries was well investigated, 15 but information on CT‐P13‐associated tuberculosis risk and hepatotoxicity in Asian patients with IBD is insufficient. 16 Therefore, it is especially important to explore the safety profile of CT‐P13 including tuberculosis risk and hepatic injury in this region.…”