title: Do HIV-positive adult immigrants need to be screened for measles-mumps-rubella and varicella zoster virus immunization?
abstract: A systematic screening for measles, mumps, rubella (MMR) and varicella zoster virus (VZV) in HIV-positive adult immigrants in Spain was evaluated, and factors associated with MMR and VZV vaccines' indication were studied. Every HIV-positive immigrant was tested for VZV and MMR-IgG. MMR vaccine was indicated to patients with lymphocytes CD4+ >200 cells/mm³ and a negative measles-IgG, a negative mumps-IgG and/or a negative rubella-IgG. VZV vaccine was indicated to every VZV-IgG negative patient with CD4+ >400 cells/mm³. In total, 289 patients were screened; seroprevalence was 95.2%, 92.2%, 70.3% and 89.3% for VZV, measles, mumps and rubella IgG, respectively. Having a negative VZV-IgG was statistically associated with coming from sub-Saharan Africa (prevalence ratio [PR]: 6.52; 95% CI: 1.71-24.84; p=0.006), while having secondary education was a protective factor (PR: 0.25; 95% CI: 0.07-0.97; p=0.045). Fourteen patients (4.8%) had indication of VZV vaccine; vaccination was feasible in 21.4% of them at first visit. Eighty-one patients (29.7%) had indication of MMR vaccine, most of them due to mumps-IgG negative (53.1%) or rubella-IgG negative (24.7%). Age < 30 years at first visit was the only factor statistically associated with MMR vaccine indication (PR: 1.47; 95% CI: 1.02-2.11; p=0.04). According to CD4+ cell counts, vaccination was feasible in 71.6% of patients at first visit. In conclusion, more than a third of HIV-infected immigrant patients are susceptible to at least one easily preventable infectious disease. Especial attention should be given to immigrant women of childbearing age.
authors.affiliation: HIV Unit, Instituto de Investigación Hospital 12 de Octubre (i + 12), Universidad Complutense, Madrid, Spain. jaravih12@gmail.com
authors.forename: Jara
authors.initials: J
authors.lastname: Llenas-García
authors.forename: Rafael
authors.initials: R
authors.lastname: Rubio
authors.forename: Asunción
authors.initials: A
authors.lastname: Hernando
authors.forename: Pilar
authors.initials: P
authors.lastname: Arrazola
authors.forename: Federico
authors.initials: F
authors.lastname: Pulido
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara / Q000208:ethnology; D002644:Chickenpox / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D019433:Chickenpox Vaccine / Q000276:immunology*; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000276:immunology*; D014645:Herpesvirus 3, Human / Q000276:immunology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008457:Measles / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D008459:Measles virus / Q000276:immunology; D022542:Measles-Mumps-Rubella Vaccine / Q000276:immunology*; D009107:Mumps / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D009109:Mumps virus / Q000276:immunology; D012409:Rubella / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D012412:Rubella virus / Q000276:immunology; D013030:Spain / Q000453:epidemiology
chemical_list: D019433:Chickenpox Vaccine; D022542:Measles-Mumps-Rubella Vaccine