[Long term persistence of yellow fever neutralising antibodies in elderly persons].
[Long term persistence of yellow fever neutralising antibodies in elderly persons].
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DOI：
10.1007/s13149-011-0135-7
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发表时间：
2011-10-01
期刊：
影响因子：
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通讯作者：
Consigny, P H
中科院分区：
文献类型：
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作者：
Coulange Bodilis, H;Benabdelmoumen, G;Consigny, P H
黄热病病毒在近期没有传播历史的地区重新出现，例如阿根廷北部和巴拉圭，并在非洲和拉丁美洲其他国家持续流行。因此，越来越多的旅行者面临感染这种疾病的风险。人口老龄化，有时患有多种疾病。此外，与减毒活 YF17D 疫苗相关的严重不良事件（例如多器官衰竭 (YEL-AVD)）的风险在 65 岁以上人群中达到 1/50,000，而在普通人群中为 1/200,000。我们在一项回顾性研究中分析了 60 岁及以上人群的黄热病中和抗体滴度结果，这些人之前接种过黄热病疫苗，并在 2005 年 1 月至 2009 年 2 月期间访问过巴斯德研究所国际疫苗接种中心。在这 84 人（中位年龄 69 岁）的人群中，最后一次疫苗接种的日期总是超过 10 年：在 68 名受试者中准确得知，并声称在16 个科目。自上次接种疫苗以来的中位时间为 14 年，最长为 60 年。血清学检查的指征为：免疫抑制治疗（19％的病例）、癌症（32％）、血液病（10.7％）、HIV感染（3.6％）、慢性肝炎/慢性肾衰竭/透析（2.4％）、自身免疫性疾病（2.4％），并且在29.8％的病例中，仅年龄是血清学检查的指征。 95.2%的病例抗体滴度处于保护水平。这四名血清学呈阴性的人没有正式记录证明之前接种过黄热病疫苗。这项血清学研究能够显示出持续的保护性抗体滴度，在上次接种疫苗后，甚至可以追溯到 60 年前，允许患者在有禁忌症的情况下在黄热病流行地区旅行，并且不需要任何疫苗加强剂。
The activity of the yellow fever virus is reemerging in areas without recent transmission history, such as northern Argentina and Paraguay, and persists in an epidemic mode in other countries in Africa and Latin America. Thus more and more travelers are at risk of being exposed to this disease. The population is becoming older, sometimes suffering from multiple pathologies. Moreover, the risk of serious adverse events associated with live-attenuated YF17D vaccine, such as multiple organ failure (YEL-AVD), reaches 1/50,000 vaccines in people over 65 versus 1/200,000 in the general population. We analyzed, in a retrospective study, the results of neutralizing antibody titers against yellow fever in people aged 60 and older, who had been previously vaccinated against yellow fever and had visited the International Vaccination Centre of the Institut Pasteur between January 2005 and February 2009. In this population of 84 persons (median age 69 years), the date of the last vaccination was always more than 10 years: it was precisely known in 68 subjects and alleged in 16 subjects. The median time since the previous vaccination was 14 years, with a maximum of 60 years. The indications of serology were: immunosuppressive therapy (19% of cases), cancer (32%), hemopathy (10.7%), HIV infection (3.6%), chronic hepatitis/chronic renal failure/dialysis (2.4%), autoimmune diseases (2.4%), and in 29.8% of cases, age alone was the indication of serology. The antibody titer was at a protective level in 95.2% of cases. The four individuals with negative serology had no formal documented proof of a previous vaccination against yellow fever. This serological study was able to show a persistent protective antibody titer, after a previous vaccination, even going back 60 years, allowing patients to travel in a yellow-fever endemic area despite a contraindication, and without requiring any vaccine booster.