Seroprevalence of common vaccine-preventable viral infections in HIV-positive adults

Abstract

Summary objectives: Guidelines recommend a proactive approach for offering vaccination to susceptible HIV-infected patients. The size of the HIV-positive population that remains susceptible to vaccine-preventable infections is largely unknown. The study determined serostatus and recalled infection and vaccination history for measles, mumps, rubella, varicella-zoster virus (VZV), hepatitis A, and hepatitis B among HIV-positive adults accessing routine care.

Methods: The study recruited 200 consecutive patients with a median CD4 count of 461 (interquartile range 326, 641) cells/mm(3); 62.5% were on suppressive antiretroviral therapy. Patients underwent serological testing and completed a questionnaire about recalled infection and vaccination history.

Results: Seronegativity rates were 7.0% [95% confidence interval 3.9-11.5%] for measles, 12.0% [7.5-16.5%] for mumps, 5.0% [2.4-9.0%] for rubella, 1.5% [0.3-4.3%] for VZV, 19.5% [14.0-25.0%] for hepatitis A, and 22.5% [16.7-28.3%] for hepatitis B. For hepatitis B, seropositivity rates were 6.5% [3.5-10.9%] for surface antigen, 38.0% [31.3-44.7%] for anti-core antibody, and 33.0% [26.5-39.5%] for anti-surface antibody alone. While patients who recalled a history of infection were generally seropositive, up to 50.5% of patients were unsure of their vaccination history.

Conclusions: A proportion of HIV-positive adults lack evidence of immunity against common, vaccine-preventable viral infections. Efforts are needed to improve knowledge and records of vaccination history.