Key result
Among 266 nonparalyzed patients with primary immunodeficiency, prospective screening identified an asymptomatic vaccine-derived poliovirus infection rate of 2.6%, with the highest risk in severe combined immunodeficiency patients (28.6%).
Why the study?
Patients with immunodeficiency-associated vaccine-derived poliovirus are potential poliovirus reservoirs in the posteradication era that might reintroduce polioviruses into the community.
Does poliovirus screening improve the detection of vaccine-derived poliovirus infection in patients with primary immunodeficiency?
Observational (n=266)
Does poliovirus screening improve the detection of vaccine-derived poliovirus infection in patients with primary immunodeficiency?
Screening nonparalyzed patients with primary immunodeficiency reveals a higher than expected rate of asymptomatic vaccine-derived poliovirus infection, highlighting its importance in polio eradication efforts.
Supports iVDPV screening in nonparalyzed PID patients; leaves open transmission risks for eradication programs.
Patients with immunodeficiency-associated vaccine-derived poliovirus (iVDPV) are potential poliovirus reservoirs in the posteradication era that might reintroduce polioviruses into the community. We update the iVDPV registry in Iran by reporting 9 new patients. In addition to national acute flaccid paralysis surveillance, cases were identified by screening nonparalyzed primary immunodeficiency (PID) patients. Overall, 23 iVDPV patients have been identified since 1995. Seven patients (30%) never had paralysis. Poliovirus screening accelerated the iVDPV detection rate in Iran after 2014.The iVDPV infection rate among nonparalyzed patients with adaptive PID was 3.1% (7/224), several folds higher than previous estimates. Severe combined immunodeficiency patients had the highest risk for asymptomatic infection (28.6%) compared with other PIDs. iVDPV2 emergence has decreased after the switch from trivalent to bivalent oral poliovirus vaccine in 2016. However, emergence of iVDPV1 and iVDPV3 continued. Poliovirus screening in PID patients is an essential step in the endgame of polio eradication.
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Shaghaghi et al. (2019) conducted an observational in Primary immunodeficiency (n=266). Primary immunodeficiency was evaluated on Asymptomatic immunodeficiency-associated vaccine-derived poliovirus (iVDPV) infection rate. Among 266 nonparalyzed patients with primary immunodeficiency, prospective screening identified an asymptomatic vaccine-derived poliovirus infection rate of 2.6%, with the highest risk in severe combined immunodeficiency patients (28.6%).
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