Laboratory evidence of retained immunity to exanthematous viruses in primary and secondary immunodeficiency

BackgroundWaning immunity to common exanthematous viruses has been observed in vaccinated immunocompetent persons and adult-onset secondary immunodeficiency patients. However, there is a paucity of data on humoral immunity from adult-onset primary immunodeficiency patients. ObjectiveAssessment of antibody seroprevalence to common exanthematous viruses in adult-onset common variable immunodeficiency (CVID) and secondary antibody deficiency (SeAD). MethodsRetrospective evaluation of IgG levels against tetanus, measles, mumps, rubella and varicella zoster virus, and pre/postvaccination IgG levels against Haemophilus influenzae type b (Hib) and a pneumococcal serotype panel. ResultsAntibody responses from 50 patients with CVID and 49 with SeAD were available. Humoral immunity against exanthematous viruses at diagnosis in the CVID/SeAD cohorts was present in 55.3%/82.2% (measles), 39.6%/73.9% (mumps), 77.8%/93.2% (rubella), 59.6%/82. 2% (varicella zoster). Pneumococcal and Hib postvaccination responses were deficient in the CVID cohort and 28% and 32% in the SeAD cohort. ConclusionAntibody responses to exanthematous viruses were more commonly retained compared to postvaccination anti-bacterial polysaccharide responses in both cohorts. SummarySeroprevalence assessment of exanthematous viruses in antibody deficiency patients revealed retained immunity, in contrast to antibacterial postvaccination responses. Retained antiviral immunity was more likely in secondary antibody deficiency patients. These results are suggestive of retained clinical protection against exanthematous viruses.