Influenza in immunosuppressed populations: a review of infection frequency, morbidity, mortality, and vaccine responses

被引:409
作者
Kunisaki, Ken M. [1 ,2 ]
Janoff, Edward N. [3 ,4 ]
机构
[1] Minneapolis VA Med Ctr, Pulm Sect, Minneapolis, MN 55417 USA
[2] Univ Minnesota, Div Pulm Allergy Crit Care & Sleep Med, Minneapolis, MN USA
[3] Univ Colorado Denver, Mucosal & Vaccine Res Ctr, Div Infect Dis, Sch Med, Aurora, CO USA
[4] Denver Vet Affairs Med Ctr, Denver, CO USA
关键词
HUMAN-IMMUNODEFICIENCY-VIRUS; HUMORAL IMMUNE-RESPONSE; SYSTEMIC-LUPUS-ERYTHEMATOSUS; RESPIRATORY VIRAL-INFECTIONS; LUNG-TRANSPLANT RECIPIENTS; SERUM ANTIBODY-RESPONSE; STEM-CELL TRANSPLANTATION; DOUBLE-BLIND; RHEUMATOID-ARTHRITIS; HEALTHY-VOLUNTEERS;
D O I
10.1016/S1473-3099(09)70175-6
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Patients that are immunosuppressed might be at risk of serious influenza-associated complications. As a result, multiple guidelines recommend influenza vaccination for patients infected with HIV, who have received solid-organ transplants, who have received haemopoietic stem-cell transplants, and patients on haemodialysis. However, immunosuppression might also limit vaccine responses. To better inform policy, we reviewed the published work relevant to incidence, outcomes, and prevention of influenza infection in these patients, and in patients being treated chemotherapy and with systemic corticosteroids. Available data suggest that most immunosuppressed populations are indeed at higher risk of influenza-associated complications, have a general trend toward impaired humoral vaccine responses (although these data are mixed), and can be safely vaccinated-although longitudinal data are largely lacking. Randomised clinical trial data were limited to one study of HIV-infected patients with high vaccine efficacy. Better trial data would inform vaccination recommendations on the basis of efficacy and cost in these at-risk populations.
引用
收藏
页码:493 / 504
页数:12
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