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Patients with systemic inflammatory and autoimmune diseases are at risk of vaccine-preventable illnesses.
MedLine Citation:
PMID:  21258052     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective. To evaluate vaccine coverage and humoral immunity to tetanus, diphtheria and poliomyelitis in adults followed for systemic inflammatory and/or autoimmune diseases (SIADs). Methods. A cross-sectional study was conducted between June and August 2006 in a monocentric cohort of adults with SIAD. A standardized questionnaire was administered to collect medical, therapeutic and vaccine coverage data. Blood samples were collected in order to measure antibody titres against diphtheria, tetanus and poliomyelitis (DTP). Results. One hundred and eighty-six patients, 32% males, mean (s.d.) age 51 (16) years, 79% receiving CSs and/or immunosuppressants, were included. The vaccine coverage was 29% for diphtheria, 48% for tetanus and 33% for poliomyelitis. The percentages of patients with no humoral immunity against DTP were 44, 21 and 12%, respectively, decreasing to 37.5, 10 and 0%, respectively, for those who had received a vaccine booster in the last 10 years. In a multivariate analysis, age and CS treatment were associated with the absence of humoral immunity against diphtheria and female sex, CD4(+) T cell <200/mm(3) and an absence of tetanus vaccine booster in the last 10 years with the absence of humoral immunity to tetanus. Conclusion. Vaccine coverage against tetanus, diphtheria and poliomyelitis is low in patients with SIAD despite the risk in this population of severe infection, especially when receiving immunosuppressants. A significant proportion of them had no humoral immunity against diphtheria or tetanus. Specific immunization schedules need to be optimized in these patients.
Authors:
Cecile Marchand-Janssen; Pierre Loulergue; Luc Mouthon; Alfred Mahr; Philippe Blanche; Lionel Deforges; Pierre Lebon; Pascal Cohen; Christian Pagnoux; Veronique Le Guern; Boris Bienvenu; Achille Aouba; Loïc Guillevin; Odile Launay
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-21
Journal Detail:
Title:  Rheumatology (Oxford, England)     Volume:  -     ISSN:  1462-0332     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883501     Medline TA:  Rheumatology (Oxford)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Université Paris Descartes, Faculté de Médecine; Inserm, CIC BT505; Assistance Publique Hôpitaux de Paris (AP-HP), Groupe Hospitalier Cochin-Saint Vincent de Paul, Pôle de Médecine, CIC de Vaccinologie Cochin-Pasteur, Université Paris Descartes, Faculté de Médecine, Pôle de Médecine Interne, Centre de Référence pour les Vascularites Nécrosantes et la Sclérodermie Systémique, Hôpital Cochin, AP-HP, Paris, Laboratoire de bactériologie, AP-HP, Groupe Hospitalier Henri Mondor, Créteil, Service de Virologie, AP-HP, Groupe Hospitalier Cochin-Saint Vincent de Paul, Paris and Service de Médecine Interne, CHRU de Caen, Avenue de la Côte de Nacre, Caen, France.
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