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Long-term immune response to yellow fever vaccination in HIV-infected individuals depends on HIV-RNA suppression status : implications for vaccination schedule

Veit, Olivia and Domingo, Cristina and Niedrig, Matthias and Staehelin, Cornelia and Sonderegger, Beat and Héquet, Delphine and Stoeckle, Marcel and Calmy, Alexandra and Schiffer, Veronique and Bernasconi, Enos and Flury, Domenica and Hatz, Christoph and Zwahlen, Marcel and Furrer, Hansjakob and Swiss HIV Cohort Study, . (2018) Long-term immune response to yellow fever vaccination in HIV-infected individuals depends on HIV-RNA suppression status : implications for vaccination schedule. Clinical Infectious Diseases, 66 (7). pp. 1099-1108.

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Official URL: https://edoc.unibas.ch/69260/

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Abstract

In human immunodeficiency virus (HIV)-infected individuals, the immune response over time to yellow fever vaccination (YFV) and the necessity for booster vaccination are not well understood.; We studied 247 participants of the Swiss HIV Cohort Study (SHCS) with a first YFV after HIV diagnosis and determined their immune responses at 1 year, 5 years, and 10 years postvaccination by yellow fever plaque reduction neutralization titers (PRNTs) in stored blood samples. A PRNT of 1:≥10 was regarded as reactive and protective. Predictors of vaccination response were analyzed with Poisson regression.; At vaccination, 82% of the vaccinees were taking combination antiretroviral therapy (cART), 83% had suppressed HIV RNA levels (<400 copies/mL), and their median CD4 T-cell count was 536 cells/μL. PRNT was reactive in 46% (95% confidence interval [CI], 38%-53%) before, 95% (95% CI, 91%-98%) within 1 year, 86% (95% CI, 79%-92%) at 5 years, and 75% (95% CI, 62%-85%) at 10 years postvaccination. In those with suppressed plasma HIV RNA at YFV, the proportion with reactive PRNTs remained high: 99% (95% CI, 95%-99.8%) within 1 year, 99% (95% CI, 92%-100%) at 5 years, and 100% (95% CI, 86%-100%) at 10 years.; HIV-infected patients' long-term immune response up to 10 years to YFV is primarily dependent on the control of HIV replication at the time of vaccination. For those on successful cART, immune response up to 10 years is comparable to that of non-HIV-infected adults. We recommend a single YFV booster after 10 years for patients vaccinated on successful cART, whereas those vaccinated with uncontrolled HIV RNA may need an early booster.
Faculties and Departments:03 Faculty of Medicine > Departement Public Health > Sozial- und Präventivmedizin > Medical Services (Neumayr)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Medicine (MED) > Medical Services (Neumayr)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
UniBasel Contributors:Hatz, Christoph
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Oxford University Press
ISSN:1058-4838
e-ISSN:1537-6591
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:05 Mar 2019 14:12
Deposited On:05 Mar 2019 14:12

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