Document Type : Original Research

Authors

1 Clinical Research Dept., Pasteur Institute of Iran, Tehran, Iran

2 Iranian Society for Support of Patients with Infectious Diseases, Tehran, Iran

Abstract

Background and Objectives: HIV infected patients are at risk for vaccine-preventable infections such as tetanus and diphtheria (Td). In these patients, these antibodies tend to decline faster. Due to the limited data, this study assessed the seroprevalence of tetanus and diphtheria antibodies in HIV infected patients in Tehran, Iran.
Materials and Methods: This case-control study was carried out in 180 HIV infected patients from Iranian HIV/AIDS Research Center in Tehran and 90 matched healthy controls. The serum samples were checked with ELISA for tetanus and diphtheria antibodies.
Results:A total of 180 HIV positive patients with mean age 36.9±9.2 years and 90 matched controls were enrolled in the study. Tetanus antibody was lower in HIV group when compared with control group. There was no significant difference in the mean serum levels of diphtheria antibody in HIV positive patients when compared with the controls. About 93.3% and 96.6% of HIV infected patients had protective diphtheria and tetanus antibodies respectively. Mean tetanus and diphtheria antibodies levels were not significantly different based on the circulating CD4+ cells.
Conclusion: HIV positive cases, who had received primary Td vaccination before they contracted HIV infection, can be expected to be protected against diphtheria, whereas revaccination against tetanus must be considered.
 

Keywords

  1. Gentile A, Bhutta Z, Bravo L, Samy AG, Garcia RD, Hoosen A, et al. Pediatric disease burden and vaccination recommendations: understanding local differences. Int J Infect Dis 2010;14(8):e649-58
  2. Zarei S, Jeddi-Tehrani M, Akhondi MM, Zeraati H, Pourheidari F, Ostadkarampour M, et al. Primary immunization with a triple diphtheria-tetanus-whole cell pertussis vaccine in Iranian infants: an analysis of antibody response. Iran J Allergy Asthma Immunol 2009;8(2):85-93.
  3. Movahedi M, Haghdoost AA, Pournik O, Hajarizadeh B, Fallah MS. Temporal variations of health indicators in Iran comparing with other Eastern Mediterranean Region countries in the last two decades. J Public Health 2008;30(4):499-504.
  4. Zolopa AR, Kemper CA, Shiboski S, Hamilton JR, Moss AR, Deresinski SC. Progressive immunodeficiency due to infection with human immunodeficiency virus does not lead to waning immunity to measles in a cohort of homosexual men. Clin Infect Dis 1994;18:636–8.
  5. World Health Organization (WHO). EPI vaccines in HIV-infected individuals. Geneva: WHO-Vaccines, immunization and biologicals; 2001. Available at: http://www.who.int/vaccines-diseases/diseases/HIV.shtml. Accessed 30 April 2003.
  6. Bonetti TC, Succi RC, Weckx LY, Tavares-Lopes L, de Moraes-Pinto MI. Tetanus and diphtheria antibodies and response to a booster dose in Brazilian HIV-1-infected women. Vaccine 2004;22(27-28):3707-12.
  7. Kroon FP, van Dissel JT, Labadie J, van Loon AM, van Furth R. Antibody response to diphtheria, tetanus, and poliomyelitis vaccines in relation to the number of CD4+ T lymphocytes in adults infected with human immunodeficiency virus. Clin Infect Dis 1995;21(5):1197-203.
  8. Salawu L, Ndakotsu MA. Tetanus antibody in Nigerians living with HIV/AIDS: A preliminary report. Malays J Microbiol 2010;6(2):111-114.
  9. Kurtzhals JA, Kjeldsen K, Heron I, Skinhøj P. Immunity against diphtheria and tetanus in human immunodeficiency virus-infected Danish men born 1950-59. APMIS 1992;100(9):803-8.
  10. Teeuwsen UJP, Logtenberg T, Siebelink KHJ, Lange JM, GoudsmitJ, Uytdehaag FG, et al. Analysis of the antigen- and mitogen-induced differentiation of B lymphocytes from asymptomatic human immunodeficiency virus seropositive male homosexuals. J Immunol 1987;139:2929–35.
  11. Janoff EN, Hardy WD, Smith PD, Wahl SM. Humoral recall response in HIV infection. Levels, specificity, and affinity of antigen-specific IgG. J Immunol 1991;147:2130–5.
  12.  de Moraes-Pinto MI, Almeida ACM, Kenj G, Filgueiras TE, Tobias W, Santos AM, et al. Placental transfer and maternally acquired neonatal IgG immunity in human immunodeficiency virus infection. J Infect Dis 1996;173:1077–84.
  13. Dieye TN, Sow PS, Simonart T, Gueye-Ndiaye A, Popper SJ, Delforge ML, et al. Immunological and virologic response after tetanus toxoid booster among HIV-1 and HIV-2 infected Senegales individuals. Vaccine 2002;20:905–13.