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

AIDS Care. 2013 Aug;25(8):980-9. doi: 10.1080/09540121.2012.748881. Epub 2012 Dec 17.

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.

MeSH terms

  • Adult
  • Africa South of the Sahara / ethnology
  • Chickenpox / epidemiology
  • Chickenpox / immunology
  • Chickenpox / prevention & control
  • Chickenpox Vaccine / immunology*
  • Cross-Sectional Studies
  • Emigrants and Immigrants / statistics & numerical data*
  • Female
  • HIV Infections / epidemiology
  • HIV Infections / immunology*
  • Herpesvirus 3, Human / immunology
  • Humans
  • Male
  • Mass Screening / methods*
  • Measles / epidemiology
  • Measles / immunology
  • Measles / prevention & control
  • Measles virus / immunology
  • Measles-Mumps-Rubella Vaccine / immunology*
  • Mumps / epidemiology
  • Mumps / immunology
  • Mumps / prevention & control
  • Mumps virus / immunology
  • Rubella / epidemiology
  • Rubella / immunology
  • Rubella / prevention & control
  • Rubella virus / immunology
  • Spain / epidemiology

Substances

  • Chickenpox Vaccine
  • Measles-Mumps-Rubella Vaccine