PT  - JOURNAL ARTICLE
AU  - Victoria Furer
AU  - Christien Rondaan
AU  - Marloes Heijstek
AU  - Sander van Assen
AU  - Marc Bijl
AU  - Nancy Agmon-Levin
AU  - Ferdinand C Breedveld
AU  - Raffaele D'Amelio
AU  - Maxime Dougados
AU  - Meliha Crnkic Kapetanovic
AU  - Jacob M van Laar
AU  - Annette Ladefoged de Thurah
AU  - Robert Landewé
AU  - Anna Molto
AU  - Ulf Müller-Ladner
AU  - Karen Schreiber
AU  - Leo Smolar
AU  - Jim Walker
AU  - Klaus Warnatz
AU  - Nico M Wulffraat
AU  - Ori Elkayam
TI  - 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
AID  - 10.1136/rmdopen-2019-001041
DP  - 2019 Sep 01
TA  - RMD Open
PG  - e001041
VI  - 5
IP  - 2
4099  - http://rmdopen.bmj.com/content/5/2/e001041.short
4100  - http://rmdopen.bmj.com/content/5/2/e001041.full
SO  - RMD Open2019 Sep 01; 5
AB  - Objectives 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.Methods 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.Results 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.Conclusion Current evidence shows an increased risk of VPI in patients with AIIRD, emphasising that prevention of infections is essential in these patients.