STRENGTH OF ANTI-DIPHTHERIA AND ANTI-TETANUS IMMUNITY IN HIV-INFECTED ADULTS

Revenko H. O.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Effective antiretroviral therapy has transformed HIV into a manageable disease, therefore the issue of immunological prophylaxis of infectious diseases among these patients arises. Diphtheria and tetanus can only be prevented by vaccination. The purpose of the study was to assess the status of post-vaccination immunity against diphtheria and tetanus by investigating the seroprevalence of antibodies against these infections in HIV-infected adults. The total of 90 HIV-infected patients aged 22 to 60 years were examined (main group). The control group consisted of 49 immunocompetent volunteers of the corresponding age. Determination of the anti-diphtheria and anti-tetanus antibodies levels was carried out by means of immunoassay analysis using RIDASCREEN Diphtheria IgG and RIDASCREEN Tetanus IgG (R-Biopharm AG, Germany) diagnostic test systems. Statistical processing was performed using the STATISTICA v.6.1 licensed software. Significant differences were found between the titers of anti-toxic antibodies in HIV-infected and immunocompetent adults. The median of antidiphtherial antibodies in HIV-positive individuals was 0.17 (0.09-0.38) IU/ml, which is by 6.1 times lower than that in the control group – 1.03 (0.56-1.27) IU/ml (p<0.001 by the Mann-Whitney criterion). The median of anti-tetanus antibodies in the main group was 0.59 (0.28-1.09) IU/ml, which is by 2.3 times less than that in the control group – 1.33 (1.13-1.45) IU/ml (p<0.001). The population unprotected against diphtheria among the main group was 93.3% (n=84), against tetanus – 52.2% (n=47). There was no reliable association between the levels of antitoxic antibodies against diphtheria and tetanus and the number of CD4+ T-lymphocytes in HIV-infected individuals. HIV-positive adults constitute a risk group for potential diphtheria and tetanus as they have low specific immunity. It justifies their mandatory vaccination against these infectious diseases.

HIV infection, vaccination, immunity, seroprevalence, diphtheria, tetanus.

1. Bhatt B, Jindal H, Sk S, Malik JS, Sangwan K, Resident J. Vaccination in HIV positive adults: need to address. Hum Vaccin Immunother. 2014 Oct;10(10):3011-2. DOI: 10.4161/21645515.2014.971645
2. Cioe PA, Melbourne K, Larkin J. An immunization update for HIV-infected adults in the United States: review of the literature. J Assoc Nurses AIDS Care. 2015 Mar-Apr;26(2):201-7. DOI: 10.1016/j.jana.2014.11.006
3. Bonanni P, Bonaccorsi G, Lorini C, Santomauro F, Tiscione E, Boccalini S, et al. Focusing on the implementation of 21st century vaccines for adults. Vaccine. 2018 Aug 28;36(36):5358-65. DOI: 10.1016/j.vaccine.2017.07.100
4. Cunha GH, Galvao MT, Medeiros CM, Rocha RP, Lima MA, Fechine FV. Vaccination status of people living with HIV/AIDSin outpatient care in Fortaleza, Ceará, Brazil. Braz J Infect Dis. 2016 Sep-Oct;20(5):487-93. DOI: 10.1016/j.bjid.2016.07.006
5. Rubin LG, Levin MJ, Ljungman P, Davies EG, Avery R, Tomblyn M, et al. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis. 2014 Feb;58(3):309-18. DOI: 10.1093/cid/cit816
6. Lopez A, Mariette X, Bachelez H, Belot A, Bonnotte B, Hachulla E, et al. Vaccination recommendations for the adult immunosuppressed patient: a systematic review and comprehensive field synopsis. J Autoimmun. 2017 Jun;80:10-27. DOI: 10.1016/j.jaut.2017.03.011
7. Geretti AM, Brook G, Cameron C, Chadwick D, French N, Heyderman R, et al. British HIV Association Guidelines on the Use of Vaccines in HIV-Positive Adults 2015. HIV Med. 2016;17(3):2-81. DOI: 10.1111/hiv.12424
8. Arvas A. Vaccination in patients with immunosuppression. Turk Pediatri Ars. 2014 Sep 1;49(3):181-5. DOI: 10.5152/tpa.2014.2206
9. Crum-Cianflone NF, Sullivan E. Vaccinations for the HIV-Infected Adult: A Review of the Current Recommendations, Part I. Infect Dis Ther. 2017 Sep;6(3):303-31. DOI: 10.1007/s40121-017-0166-x
10. Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents [Internet]. AIDSinfo; 2018. Available from: https://aidsinfo.nih.gov/guidelines
11. Revenko GО, Маvrutenkov VV. Imunna vidpovid doroslykh liudei, yaki zhyvut z VIL-infektsiieiu, na vvedennia dyfteriinoho ta pravtsevoho anatoksyniv (ohliad literatury). Aktualna Infektolohiia. 2018;6(1):7-11. DOI: 10.22141/2312-413x.6.1.2018.125629 [in Ukrainian].
12. Pinto Neto LFDS, Vieira JV, Ronchi NR. Vaccination coverage in a cohort of HIV-infected patients receiving care at an AIDS outpatient clinic in Espírito Santo, Brazil. Braz J Infect Dis. 2017 Sep-Oct;21(5):515-9. DOI: 10.1016/j.bjid.2017.03.021
13. Poland GA, Whitaker JA, editors. Vaccinations. St. Louis, Missouri: Elsevier; 2019. 400 p. DOI: 10.1016/C2017-0-00341-5
14. Volokha AP, Raus IV, Donskoi BYe, Chernyshova LI, Chernyshov VP. Imunitet proty dyfterii ta pravtsia v ditei z VIL-infektsiieiu. Zdorove rebenka. 2016;7(75):124-9. DOI: http://dx.doi.org/10.22141/2224-0551.7.75.2016.86738 [in Ukrainian].
15. Shetty VU, Chaudhuri P, Sabella C. Rationale for the Immunization Schedule: Why Is It the Way It Is? Pediatr Rev. 2019 Jan;40(1):26-36. DOI: 10.1542/pir.2018-0033

«Bulletin of problems biology and medicine» Issue 4 (158), 2020 year, 178-182 pages, index UDK 616.98:578.828ВІЛ-053.8:612.07:616.931:616.98

10.29254/2077-4214-2020-4-158-178-182