title: Immunogenicity and safety of yellow fever vaccine among 115 HIV-infected patients after a preventive immunisation campaign in Mali.
abstract: The immune response to yellow fever (YF) vaccine and its safety among HIV-infected individuals living in YF endemic areas is not well understood. Following a national YF preventive immunisation campaign in Mali in April 2008, we assessed the immunogenicity and safety of 17D yellow fever vaccine (17DV) among HIV-infected patients in two HIV treatment centres in Bamako, Mali, by testing for neutralising antibodies and identifying serious adverse events following immunisation (AEFI). A YF neutralisation titre (NT) of 1:≥20 was considered to be adequate and protective. A serious AEFI included hospitalisation, any life-threatening condition, or death, occurring within 30 days following 17DV administration. Of 115 HIV-infected patients who reported having received 17DV, 110 (96%) were on combination antiretroviral therapy and 83 patients were tested for neutralising antibodies. Around the time of vaccination, median CD4 cell count was 389 cells/mm(3) (IQR 227-511cells/mm(3)); HIV-RNA was undetectable in 24 of 46 patients tested. Seventy-six (92%) of 83 participants had adequate immune titres 9 months after the immunisation campaign. Previous vaccination or flavivirus exposure could contribute to this finding. No serious AEFI was found in the 115 participants. In this small series, YF vaccine appeared to be immunogenic with a favourable safety profile in HIV-infected patients on antiretroviral therapy. Higher CD4 cell counts and suppressed HIV-RNA were associated with the presence of an adequate immune titre and higher NTs.
authors.affiliation: Ministry of Health, Koulouba, BP 232, Bamako, Mali.
authors.forename: Mariam
authors.initials: M
authors.lastname: Sidibe
authors.forename: Sergio
authors.initials: S
authors.lastname: Yactayo
authors.forename: Abdoulaye
authors.initials: A
authors.lastname: Kalle
authors.forename: Amadou A
authors.initials: AA
authors.lastname: Sall
authors.forename: Samba
authors.initials: S
authors.lastname: Sow
authors.forename: Modjirom
authors.initials: M
authors.lastname: Ndoutabe
authors.forename: William
authors.initials: W
authors.lastname: Perea
authors.forename: Fenella
authors.initials: F
authors.lastname: Avokey
authors.forename: Rosamund F
authors.initials: RF
authors.lastname: Lewis
authors.forename: Olivia
authors.initials: O
authors.lastname: Veit
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000187:drug effects*; D018791:CD4 Lymphocyte Count; D005260:Female; D006679:HIV Seropositivity / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology*; D006801:Humans; D007114:Immunization; D008297:Male; D008302:Mali / Q000453:epidemiology; D008875:Middle Aged; D009500:Neutralization Tests; D012367:RNA, Viral / Q000187:drug effects*; D016896:Treatment Outcome; D019562:Viral Load; D015004:Yellow Fever / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control*; D022341:Yellow Fever Vaccine / Q000008:administration & dosage / Q000276:immunology*; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D012367:RNA, Viral; D022341:Yellow Fever Vaccine