Durability of tetanus seroprotection in people living with HIV

AIDS. 2022 Jul 1;36(8):1135-1139. doi: 10.1097/QAD.0000000000003206. Epub 2022 Feb 24.

Abstract

Objectives: The aim of this study was to estimate the durability of tetanus toxoid specific seroprotection in a cohort of people with HIV (PWH).

Design: A cross-sectional study.

Methods: PWH with a last date of tetanus toxoid booster available were identified. Tetanus toxoid specific IgG were detected using commercial ELISA kit. Durability of seroprotection was estimated using a linear regression model and analyzed according to the country of birth. The impact of baseline parameters at the time of vaccination (CD4 + T cell count, viral load, and antiretroviral therapy) was also assessed.

Results: One hundred three individuals were included. The median duration between last tetanus toxoid booster and sampling was 5.6years (IQR 2.6-8.9). Using a linear regression model, half-life of tetanus toxoid specific antibody was estimated at 9.9 years [95% confidence interval (95% CI: 5.5-50)] in the whole cohort. Half-life was reduced in individuals born outside Europe: 4.4 years (95% CI: 2.9-8.5). PWH born outside Europe had lower CD4 + T cell count at the time of immunization and more frequently a CD4 + T cell count nadir less than 200 cells/μl before vaccination.

Conclusion: PWH born outside Europe have lower half-life of tetanus toxoid specific antibody as compared to previous study performed in the general population. Possible causes include lower nadir or current CD4 + T cell count or under-immunization status in country of origin before migration. Longer interval of booster vaccination, as recommended in the general population, might not be appropriate in this subgroup of PWH. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Bacterial
  • CD4 Lymphocyte Count
  • Cross-Sectional Studies
  • HIV Infections* / complications
  • HIV Infections* / drug therapy
  • Humans
  • Immunization, Secondary
  • Tetanus Toxoid
  • Tetanus* / prevention & control
  • Vaccination

Substances

  • Antibodies, Bacterial
  • Tetanus Toxoid