tetano
Editor, Senior Moderator
RMD Open. 2019 Sep 19;5(2):e001041. doi: 10.1136/rmdopen-2019-001041. eCollection 2019. [h=1]Incidence and prevalence of vaccine preventable infections in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD): a systemic literature review informing the 2019 update of the EULAR recommendations for vaccination in adult patients with AIIRD.[/h]
Furer V[SUP]1,[/SUP][SUP]2[/SUP], Rondaan C[SUP]3,[/SUP][SUP]4[/SUP], Heijstek M[SUP]5[/SUP], van Assen S[SUP]6[/SUP], Bijl M[SUP]7[/SUP], Agmon-Levin N[SUP]2,[/SUP][SUP]8[/SUP], Breedveld FC[SUP]9[/SUP], D'Amelio R[SUP]10[/SUP], Dougados M[SUP]11[/SUP], Kapetanovic MC[SUP]12[/SUP], van Laar JM[SUP]13[/SUP], Ladefoged de Thurah A[SUP]14[/SUP], Landew? R[SUP]15,[/SUP][SUP]16[/SUP], Molto A[SUP]11[/SUP], M?ller-Ladner U[SUP]17[/SUP], Schreiber K[SUP]18,[/SUP][SUP]19[/SUP], Smolar L[SUP]20[/SUP], Walker J[SUP]21[/SUP], Warnatz K[SUP]22[/SUP], Wulffraat NM[SUP]23[/SUP], Elkayam O[SUP]1,[/SUP][SUP]2[/SUP].
[h=3]Author information[/h] 1 Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. 2 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 3 Medical Microbiology and Infection Prevention, UMCG, Groningen, The Netherlands. 4 Rheumatology and Clinical Immunology, UMCG, Groningen, The Netherlands. 5 Internal Medicine and Allergology, Rheumatology and Clinical Immunology, UMC Utrecht, Utrecht, The Netherlands. 6 Internal Medicine (Infectious Diseases), Treant Care Group, Hoogeveen, The Netherlands. 7 Internal Medicine, Martini Hospital, Groningen, The Netherlands. 8 Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel. 9 Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. 10 Dipartimento di Medicina Clinica e Molecolare, Sapienza University of Rome, Roma, Italy. 11 Department of Rheumatology, H?pital Cochin, Universit? Paris Descartes, Paris, France. 12 Department of Clinical Sciences Lund, Section for Rheumatology, Lund University and Sk?ne University Hospital, Lund, Sweden. 13 Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands. 14 Institute of Clinical Medicine, Section of Rheumatology, Aarhus University Hospital, Aarhus, Denmark. 15 Clinical Immunology and Rheumatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 16 Department of Rheumatology, Zuyderland Medical Centre, Heerlen, The Netherlands. 17 Department of Rheumatology and Clinical Immunology, Justus-Liebig-University, Giessen, Germany. 18 Department of Rheumatology, King Christian X's Hospital for Rheumatic Diseases, Graasten, Denmark. 19 Department of Thrombosis and Haemophilia, Guy's and St Thomas' Hospital, London, United Kingdom. 20 Tel Aviv, Israel. 21 Elgin, UK. 22 Center for Chronic Immunodeficiency, Faculty of Medicine, University of Freiburg, University Medical Center Freiburg, Freiburg, Germany. 23 Department of Pediatric Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
[h=3]Abstract[/h] [h=4]Objectives:[/h] The aims of this study were to update the evidence on the incidence and prevalence rates of vaccine preventable infections (VPI) in patients with autoimmune inflammatory rheumatic diseases (AIIRD) and compare the data to the general population when available.
[h=4]Methods:[/h] A literature search was performed using Medline, Embase and Cochrane library (October 2009 to August 2018). The primary outcome was the incidence or prevalence of VPI in the adult AIIRD population. Meta-analysis was performed when appropriate.
[h=4]Results:[/h] Sixty-three publications out of 3876 identified records met the inclusion criteria: influenza (n=4), pneumococcal disease (n=7), hepatitis B (n=10), herpes zoster (HZ) (n=29), human papillomavirus (HPV) infection (n=13). An increased incidence of influenza and pneumococcal disease was reported in patients with AIIRD. HZ infection-pooled incidence rate ratio (IRR) was 2.9 (95% CI 2.4 to 3.3) in patients with AIIRD versus general population. Among AIIRD, inflammatory myositis conferred the highest incidence rate (IR) of HZ (pooled IRR 5.1, 95% CI 4.3 to 5.9), followed by systemic lupus erythematosus (SLE) (pooled IRR 4.0, 95% CI 2.3 to 5.7) and rheumatoid arthritis (pooled IRR 2.3, 95% CI 2.1 to 2.6). HPV infection-pooled prevalence ratio was 1.6, 95% CI 0.7 to 3.4 versus general population, based on studies mainly conducted in the SLE population in Latin America and Asia. Pooled prevalence of hepatitis B surface antigen and hepatitis B core antibody in patients with AIIRD was similar to the general population, 3%, 95% CI 1% to 5% and 15%, 95% CI 7% to 26%, respectively.
[h=4]Conclusion:[/h] Current evidence shows an increased risk of VPI in patients with AIIRD, emphasising that prevention of infections is essential in these patients.
? Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
[h=4]KEYWORDS:[/h] autoimmune diseases; epidemiology; infections; vaccination
PMID: 31673420 PMCID: PMC6803008 DOI: 10.1136/rmdopen-2019-001041
Furer V[SUP]1,[/SUP][SUP]2[/SUP], Rondaan C[SUP]3,[/SUP][SUP]4[/SUP], Heijstek M[SUP]5[/SUP], van Assen S[SUP]6[/SUP], Bijl M[SUP]7[/SUP], Agmon-Levin N[SUP]2,[/SUP][SUP]8[/SUP], Breedveld FC[SUP]9[/SUP], D'Amelio R[SUP]10[/SUP], Dougados M[SUP]11[/SUP], Kapetanovic MC[SUP]12[/SUP], van Laar JM[SUP]13[/SUP], Ladefoged de Thurah A[SUP]14[/SUP], Landew? R[SUP]15,[/SUP][SUP]16[/SUP], Molto A[SUP]11[/SUP], M?ller-Ladner U[SUP]17[/SUP], Schreiber K[SUP]18,[/SUP][SUP]19[/SUP], Smolar L[SUP]20[/SUP], Walker J[SUP]21[/SUP], Warnatz K[SUP]22[/SUP], Wulffraat NM[SUP]23[/SUP], Elkayam O[SUP]1,[/SUP][SUP]2[/SUP].
[h=3]Author information[/h] 1 Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. 2 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 3 Medical Microbiology and Infection Prevention, UMCG, Groningen, The Netherlands. 4 Rheumatology and Clinical Immunology, UMCG, Groningen, The Netherlands. 5 Internal Medicine and Allergology, Rheumatology and Clinical Immunology, UMC Utrecht, Utrecht, The Netherlands. 6 Internal Medicine (Infectious Diseases), Treant Care Group, Hoogeveen, The Netherlands. 7 Internal Medicine, Martini Hospital, Groningen, The Netherlands. 8 Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel. 9 Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. 10 Dipartimento di Medicina Clinica e Molecolare, Sapienza University of Rome, Roma, Italy. 11 Department of Rheumatology, H?pital Cochin, Universit? Paris Descartes, Paris, France. 12 Department of Clinical Sciences Lund, Section for Rheumatology, Lund University and Sk?ne University Hospital, Lund, Sweden. 13 Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands. 14 Institute of Clinical Medicine, Section of Rheumatology, Aarhus University Hospital, Aarhus, Denmark. 15 Clinical Immunology and Rheumatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 16 Department of Rheumatology, Zuyderland Medical Centre, Heerlen, The Netherlands. 17 Department of Rheumatology and Clinical Immunology, Justus-Liebig-University, Giessen, Germany. 18 Department of Rheumatology, King Christian X's Hospital for Rheumatic Diseases, Graasten, Denmark. 19 Department of Thrombosis and Haemophilia, Guy's and St Thomas' Hospital, London, United Kingdom. 20 Tel Aviv, Israel. 21 Elgin, UK. 22 Center for Chronic Immunodeficiency, Faculty of Medicine, University of Freiburg, University Medical Center Freiburg, Freiburg, Germany. 23 Department of Pediatric Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
[h=3]Abstract[/h] [h=4]Objectives:[/h] The aims of this study were to update the evidence on the incidence and prevalence rates of vaccine preventable infections (VPI) in patients with autoimmune inflammatory rheumatic diseases (AIIRD) and compare the data to the general population when available.
[h=4]Methods:[/h] A literature search was performed using Medline, Embase and Cochrane library (October 2009 to August 2018). The primary outcome was the incidence or prevalence of VPI in the adult AIIRD population. Meta-analysis was performed when appropriate.
[h=4]Results:[/h] Sixty-three publications out of 3876 identified records met the inclusion criteria: influenza (n=4), pneumococcal disease (n=7), hepatitis B (n=10), herpes zoster (HZ) (n=29), human papillomavirus (HPV) infection (n=13). An increased incidence of influenza and pneumococcal disease was reported in patients with AIIRD. HZ infection-pooled incidence rate ratio (IRR) was 2.9 (95% CI 2.4 to 3.3) in patients with AIIRD versus general population. Among AIIRD, inflammatory myositis conferred the highest incidence rate (IR) of HZ (pooled IRR 5.1, 95% CI 4.3 to 5.9), followed by systemic lupus erythematosus (SLE) (pooled IRR 4.0, 95% CI 2.3 to 5.7) and rheumatoid arthritis (pooled IRR 2.3, 95% CI 2.1 to 2.6). HPV infection-pooled prevalence ratio was 1.6, 95% CI 0.7 to 3.4 versus general population, based on studies mainly conducted in the SLE population in Latin America and Asia. Pooled prevalence of hepatitis B surface antigen and hepatitis B core antibody in patients with AIIRD was similar to the general population, 3%, 95% CI 1% to 5% and 15%, 95% CI 7% to 26%, respectively.
[h=4]Conclusion:[/h] Current evidence shows an increased risk of VPI in patients with AIIRD, emphasising that prevention of infections is essential in these patients.
? Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
[h=4]KEYWORDS:[/h] autoimmune diseases; epidemiology; infections; vaccination
PMID: 31673420 PMCID: PMC6803008 DOI: 10.1136/rmdopen-2019-001041