VA Resident Report: Is there an increased risk for patients with Terminal Complement Deficiency and HIV?

The Bottom Line: The Advisory Committee on Immunization Practices has previously recommended routine vaccination of persons aged ≥2 months who have certain medical conditions that increase risk for meningococcal disease, including persons who have persistent deficiencies in the complement pathway (e.g., C3, properdin, Factor D, Factor H, or C5–C9); persons receiving eculizumab (Soliris, Alexion Pharmaceuticals) for treatment of atypical hemolytic uremic syndrome or paroxysmal nocturnal hemoglobinuria (because the drug binds C5 and inhibits the terminal complement pathway)

MacNeil, J., Rubin, L., Patton, M., Ortega-Sanchez, I., & Martin, S. (2016). Recommendations for Use of Meningococcal Conjugate Vaccines in HIV-Infected Persons – Advisory Committee on Immunization Practices, 2016. Morbidity and Mortality Weekly Report MMWR /, 65(43), 1189-1194.

In addition, ACIP recommends routine vaccination with serogroup B meningococcal (MenB) vaccine for persons who have persistent complement component deficiencies; persons who have anatomic or functional asplenia; microbiologists who routinely are exposed to isolates of N. meningitidis; and persons identified to be at increased risk because of a serogroup B meningococcal disease outbreak.

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