Immunogenicity and Tolerability of the Amaril Vaccine in Travelers Living with HIV, France, 2005.

Introduction. The Amaril vaccine (YFV, yellow fever vaccine) is a live-attenuated vaccine that is theoretically contraindicated in immunocompromised patients due to the potential risk of severe viscero- or neurotropic vaccine-associated disease. Methods. A retrospective study of travelers living with HIV (HIV-positive travelers) who received the YFV in 2002 or 2003 at the Bordeaux University Hospital. Immunogenicity was defined by the presence of negative seroneutralizing anti-YF antibodies (Ac-, <=5 IU/L) prior to YF vaccination, followed by positive antibodies (Ac+, >=10 IU/L) after vaccination. Results. A total of 23 HIV-positive travelers were studied. All had a CD4 count > 200/mm³ except for one who had 159 CD4 cells. We identified 12 HIV-positive travelers with a history of yellow fever vaccination, and 9 of them (75%) were immunized (Ac+) prior to the study vaccination. We observed 11 HIV-positive travelers with no history of the vaccine (Ab-), and all became immune following vaccination (Ab+). The immunogenicity of the vaccine was estimated at 93% (13/14) among HIV-positive travelers who were Ab- prior to vaccination. The time to acquire immunity appears to be longer than in the general population. No serious adverse events were reported. Conclusion. We consider the immunogenicity of the vaccine to be satisfactory but incomplete in HIV-positive travelers. We suggest a large prospective study to confirm our results.

Author(s): Pistone T, Verdiere CH, Receveur MC, Ezzedine K, Lafon ME, Malvy D

Publishing year: 2007

Pages: 238-40

Weekly Epidemiological Bulletin, 2007, n° 25-26, p. 238-40

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