Immunogenicity and tolerability of yellow fever vaccination in 23 French HIV-infected patients.
BACKGROUND
Vaccination of asymptomatic human immunodeficiency virus (HIV)-infected patients with a CD4 cell count ≥ 200/mm³ is strongly suggested prior to travel to a region where yellow fever (YF) is endemic. However, few data describing YF vaccination in such patients are available.


METHODS
In this retrospective observational study of 23 HIV-infected patients, YF antibody titers, CD4 cell counts, and viral loads were measured before and after vaccination. Serologies were performed retrospectively on samples that had been stored as part of routine hospital procedures.


RESULTS
Ninety-three percent of patients (13/14) with no baseline immunity, seroconverted after vaccination. Immunogenicity appeared slowly; only 2 of the 5 patients tested within 5 weeks of vaccination had seroconverted. A booster effect was noted in 3 of the 9 patients with baseline immunogenicity. Finally, due to unawareness of his HIV status, one patient was vaccinated and was found later to have a CD4 cell count < 200/mm³.The YF vaccine was well tolerated and no serious adverse events were reported. The impact of vaccination on immunologic and viral parameters was variable. Both decreases (n = 7) and increases (n = 5) in CD4 cell counts were recorded. Viral loads became undetectable in 2 patients and doubled or became positive in 3 patients.


CONCLUSIONS
Yellow fever vaccination was safe and effective in a large majority of this cohort of stable, HIV-infected patients.
Pistone
Thierry
T
Department of Internal Medicine and Tropical Diseases, Hôpital Saint-André, CHU, Bordeaux, France.
Verdière
Claire-Hélène
CH
Receveur
Marie-Catherine
MC
Ezzedine
Khaled
K
Lafon
Marie-Edith
ME
Malvy
Denis
D
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D058345:Asymptomatic Infections; D018791:CD4 Lymphocyte Count; D002648:Child; D005260:Female; D005602:France; D006678:HIV / Q000276:immunology*; D015658:HIV Infections / Q000150:complications / Q000276:immunology* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014195:Travel; D014611:Vaccination / Q000009:adverse effects; D019562:Viral Load; D015004:Yellow Fever / Q000276:immunology* / Q000517:prevention & control* / Q000821:virology; D022341:Yellow Fever Vaccine / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology
D000914:Antibodies, Viral; D022341:Yellow Fever Vaccine