RT Journal Article
SR Electronic
T1 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
JF RMD Open
JO RMD Open
FD EULAR
SP e001041
DO 10.1136/rmdopen-2019-001041
VO 5
IS 2
A1 Victoria Furer
A1 Christien Rondaan
A1 Marloes Heijstek
A1 Sander van Assen
A1 Marc Bijl
A1 Nancy Agmon-Levin
A1 Ferdinand C Breedveld
A1 Raffaele D'Amelio
A1 Maxime Dougados
A1 Meliha Crnkic Kapetanovic
A1 Jacob M van Laar
A1 Annette Ladefoged de Thurah
A1 Robert Landewé
A1 Anna Molto
A1 Ulf Müller-Ladner
A1 Karen Schreiber
A1 Leo Smolar
A1 Jim Walker
A1 Klaus Warnatz
A1 Nico M Wulffraat
A1 Ori Elkayam
YR 2019
UL http://rmdopen.bmj.com/content/5/2/e001041.abstract
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.