PREDICTORS OF ANTITOXIC ANTI-DIPHTHERIA IMMUNITY STRENGTH IN HIV-INFECTED ADULTS
DOI:
https://doi.org/10.11603/1681-2727.2021.2.12161Keywords:
HIV infection, diphtheria, immunity, adultsAbstract
The aim of the study was to assess the intensity of immunity against diphtheria in HIV-infected adults and to investigate its relationship with the main clinical and laboratory indicators to determine the predictors of the integrated use of these factors. The study included 90 patients with HIV aged 22 to 60 years, the average age was (40.1±0.9) years, men –39 (43.3 %), women – 51 (56.7 %). The control group included 49 healthy immunocompetent volunteers of the appropriate age group and gender composition. We found that the median of diphtheria antibodies was 0.17 (0.09–0.38) IU/ml, which is 6.1 times lower than in the control group – 1.03 (0.56–1.27) IU/ml (p<0.001 by U-test).
High risk of absence or low levels of diphtheria antibodies significantly (from p<0.05 to p<0.001) is associated with anemia, thrombocytopenia, elevated ESR, low levels of T-helpers (nadir), the presence of tongue leukoplakia, body weight deficit, smoking. The greatest protective opportunities to increase the level of anti-diphtheria immunity in HIV-infected adults, respectively, are associated with the receipt of injectable drug replacement therapy (rs=0.57; p=0.002), the absence of hairy leukoplakia of the tongue (rs=-0.23; p=0.030), smoking cessation (rs=-0.26; p=0.013), normal laboratory blood counts (hemoglobin level – rs = 0.25; p=0.02, platelets – rs=0 .41; p<0.001, ESR – rs=-0.55; p<0.001) and body weight – rs=0.31; p=0.003), as well as more T-helpers (nadir) – (rs=0.49 (p<0.001).
A comprehensive assessment of these factors will allow, without conducting special studies, to identify risk groups that require vaccination against diphtheria.
References
Bonanni, P., Bonaccorsi, G., Lorini, C., Santomauro, F., Tiscione, E., Boccalini, S., & Bechini, A. (2018). Focusing on the implementation of 21st century vaccines for adults. Vaccine, 36 (36), 5358-65. DOI: 10.1016/j.vaccine.2017.07.100.
Crum-Cianflone, N.F., & Sullivan, E. (2017). Vaccinations for the HIV-infected adult: A review of the current recommendations, part I. Infect. Dis. Ther., 6 (3), 303-331. DOI: 10.1007/s40121-017-0166-x.
Cunha, G.H., Galvao, M.T., Medeiros, C.M., Rocha, R.P., Lima, M.A., & Fechine, F.V.(2016). Vaccination status of people living with HIV/AIDSin outpatient care in Fortaleza, Ceará, Brazil. Braz. J. Infect. Dis., 20 (5), 487-493. DOI: 10.1016/j.bjid.2016.07.006.
Revenko, H.O., Mavrutenkov, V.V., & Chykarenko, Z.O. (2020). Clinical and laboratory predictors of antitoxic immunity against diphtheria and tetanus in adults with HIV infection. Medicni perspektivi – Medical Perspectives, 25 (3), 117-124. DOI: https://doi.org/10.26641/2307-0404.2020.3.214846.
Revenko, H.O. (2020). Strength of anti-diphtheria and anti-tetanus immunity in HIV-infected adults. Bulletin of Problems Biology and Medicine, 158 (4), 178-182. DOI:10.29254/2077-4214-2020-4-158-178-182.
Lytvyn, К.Y. (2018). Main characteristics and risks of HIV-associated tuberculous lesions of the nervous system. Actual problems of modern medicine: Bulletin of the Ukrainian Medical Dental Academy, Vol. 18(62), 65-69 [in Ukrainian].
Revenko, G.O., & Маvrutenkov, V.V. (2018). Immune response of adult people living with human immunodeficiency virus to the introduction of diphtheria and tetanus toxoid (review of literature). Аctual Infectology, 6 (1), 7-11. DOI: 10.22141/2312-413x.6.1.2018.125629.
Grabmeier-Pfistershammer, K., Herkner, H., Touzeau-Roemer, V., Rieger, A., Burgmann, H., & Poeppl, W. (2015). Low tetanus, diphtheria and acellular pertussis (Tdap) vaccination coverage among HIV infected individuals in Austria. Vaccine, 33 (32), 3929-3932. DOI: 10.1016/j.vaccine.2015.06.056.
Dlamini, S.K., Madhi, S.A., Muloiwa, R., von Gottberg, A., Moosa, M.S., Meiring, S.T., Wiysonge, C.S., Hefer, E., Mulaudzi, M.B., Nuttall, J., Moorhouse, M., & Kagina, B.M. (2018). Guidelines for the vaccination of HIV-infected adolescents and adults in South Africa. Southern African Journal of HIV Medicine, 19 (1), 1-8. DOI: https://doi.org/10.4102/sajhivmed.v19i1.839.
El Chaer, F., & El Sahly, H.M. (2019). Vaccination in the Adult Patient Infected with HIV: A Review of Vaccine Efficacy and Immunogenicity. Am J Med., 132 (4), 437-446. DOI: 10.1016/j.amjmed.2018.12.011.
Pinto Neto, L.F.D.S., Vieira, J.V., & Ronchi, N.R. (2017). Vaccination coverage in a cohort of HIV-infected patients receiving care at an AIDS outpatient clinic in Espírito Santo, Brazil. Braz. J. Infect. Dis., 21 (5), 515-519. DOI: 10.1016/j.bjid.2017.03.021.
Volokha, A., Raus, I., Donskoy, B., Chernyshova, L, & Chernyshov, V. (2016). Immunity against diphtheria and tetanus in HIV-infected children. Child Health, 75 (7), 124-129. DOI: 10.22141/2224-0551.7.75.2016.86738.
Simani, O.E., Izu, A., Nunes, M.C., Violari, A., Cotton, M.F., Niekerk N.V, Adrian P.V, & Madhi S.A. (2019). Effect of HIV exposure and timing of antiretroviral therapy initiation on immune memory responses to diphtheria, tetanus, whole cell pertussis and hepatitis B vaccines. Expert Rev. Vaccines, 18 (1), 95-104. DOI: 10.1080/14760584.2019.1547195.
Lang, T.A., & Secic, M. (2006). How to report statistics in medicine: Annotated Guidelines for Authors, Editors, and Reviewers. edited by T.A. Lang, M. Secic. 2nd ed. Philadelphia: American College of physicians, 490p.
Mullaert, J., Abgrall, S., Lele, N., Batteux, F., Slama, L.B., Meritet, J.F., Lebon, P., Bouchaud, O., Grabar, S., & Launay, O. (2015). Diphtheria, tetanus, poliomyelitis, yellow fever and hepatitis B seroprevalence among HIV1-infected migrants. Results from the ANRS VIHVO vaccine sub-study. Vaccine, 33 (38), 4938-4944. DOI: 10.1016/j.vaccine.2015.07.036.
Speranza, F.A., Ishii, S.K., Thuler, L.C, Damasco, P.V., Hirata, Jr.R., Mattos-Guaraldi, A.L., & Milagres, L.G. (2012). Diphtheria Antibodies and T lymphocyte Counts in Patients Infected With HIV-1. Braz. J. Microbiol., 43 (3), 946-950. DOI: 10.1590/S1517-838220120003000014.
Kerneis, S., Launay, O., Turbelin, C., Batteux, F., Hanslik, T., & Boelle, P.Y. (2014). Long-term immune responses to vaccination in HIV-infected patients: a systematic review and meta-analysis. Clin. Infect. Dis., 58 (8), 1130-1139. DOI: 10.1093/cid/cit937.
Boey, L., Bosmans, E., Ferreira, L.B., Heyvaert, N., Nelen,M., Smans, L., Tuerlinckx, H., et al. (2021). Seroprevalence of antibodies against diphtheria, tetanus and pertussis in adult at-risk patients. Vaccine, 9 (1), 18. Retrieved from: https://doi.org/10.3390/vaccines9010018.
Eslamifar, A., Ramezani, A., Banifazl, M., & Aghakhani A. (2012). Tetanus and diphtheria seroprevalence in patients infected with human immunodeficiency virus. A Iranian Journal of Pathology, 7 (1), 27-31.
Petráš, M., Oleár, V., Molitorisová, M., Dáňová, J., Čelko, A.M., Nováková, E., Štefkovičová, M., et al. (2019). Factors influencing persistence of diphtheria immunity and immune response to a booster dose in healthy Slovak adults. Vaccines (Basel), 7 (4), 139. DOI: 10.3390/vaccines7040139.
Sticchi, L., Bruzzone, B., Caligiuri, P., Rappazzo, E., Lo Casto, M., De Hoffer, L., Gustinetti, G., et al. (2015). Seroprevalence and vaccination coverage of vaccine-preventable diseases in perinatally HIV-1-infected patients. Hum. Vaccin. Immunother., 11 (1), 263-2699. DOI: 10.4161/hv.36162.
Eliakim, A., Schwindt, C., Zaldivar, F., Casali P., & Cooper, D.M. (2006). Reduced tetanus antibody titers in overweight children. Autoimmunity, 39(4), 137-141. DOI: 10.1080/08916930600597326.
Sheridan, P.A., Paich, H.A., Handy, J., Karlsson, E.A., Hudgens, M.G., Sammon, A.B., Holland, L.A. et al. (2012). Obesity is associated with impaired immune response to influenza vaccination in humans. International Journal of Obesity, 36 (8), 1072-1077. DOI: 10.1038/ijo.2011.208.
Talbot, H.K., Coleman, L.A., Crimin, K., Zhu, Y., Rock, M.T., Meece, J., Shay, D.K., et al. (2012). Association between obesity and vulnerability and serologic response to influenza vaccination in older adults. Vaccine, 30 (26), 3937-3943. DOI: 10.1016/j.vaccine.2012.03.071.
Younas, M., Carrat, F., Desaint, C., Launay, O., & Corbeau, P. (2017). Immune activation, smoking, and vaccine response. AIDS, 31 (1), 171-173. DOI: 10.1097/QAD.0000000000001311
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