Tattevin P, de Patureaux A, Chapplain JM, Dupont M, Arvieux C, Poveda JD, Souala MF, Michelet C; IAS Conference on HIV Pathogenesis and Treatment (2nd : 2003 : Paris, France).
Antivir Ther. 2003; 8 (Suppl.1): abstract no. 1202.
Pontchaillou Univ Hosp, Rennes, France
BACKGROUND: Yellow fever (YF) is a highly lethal disease that can be prevented by YF vaccine 17D. Although this live attenuated virus vaccine is theoretically contra-indicated in immunocompromised patients, there are few data about its efficacy and tolerance in HIV-infected patients. METHODS: We report a retrospective study of all consecutive HIV-infected patients that were vaccinated before a trip to sub-Saharan Africa or South America with the 17D yellow fever strain (Stamaril; Pasteur Merieux Serums et Vaccins, Lyon, France) in our department between July 1995 and July 2002. The efficacy was evaluated by the measure of neutralizing YF antibody response in serum (seroneutralization, Pasteur Cerba, Pasteur Institute, Paris, France). Tolerance data were retrospectively collected: i) from the medical charts; ii) by a specific interview. RESULTS: Twelve patients (nine women, three men) were studied including two patients with previous AIDS-related events. At the time of YF vaccination, nine patients were taking antiretroviral treatment. Mean age was 39 years (22-50), mean CD4 cell count was 561 +/-363 (extremes: 240-1300), mean CD8 cell count was 947/mm3; mean viral load (VL) was 5477 +/-9662 (extremes: <20-31100). For 10 patients, CD4 count and VL during the 3 months following vaccination were available. There were no significant changes in CD4 count (542 +/-401; P=0.6) or VL (8694 +/-11098; P=0.2) compared to baseline values. For the five patients with undetectable VL (<200 copies/ml) before vaccination, VL was still undetectable after. One patient reported transient fever and pharyngitis 5 days after the vaccination. Serological values indicated a good immune response for all patients with a median YF titre of 1/40 (1/20-1/80). CONCLUSION: YF vaccine appears to be safe and effective in HIV-infected patients with CD4 cell count above 200/mm3, even if they previously developped AIDS or if their VL is above 10000 copies/ml.
Publication Types:
Keywords:
- AIDS Vaccines
- Acquired Immunodeficiency Syndrome
- Africa South of the Sahara
- CD4 Lymphocyte Count
- Female
- France
- HIV Infections
- HIV Seropositivity
- Humans
- Male
- Paris
- Retrospective Studies
- South America
- Vaccination
- Vaccines
- Viral Load
- Yellow Fever
- Yellow Fever Vaccine
Other ID:
UI: 102263475
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