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Poor Recall of Prior Exposure to Varicella Zoster, Rubella, Measles, or Mumps in Patients with IBD

Naganuma, Makoto MD, PhD; Nagahori, Masakazu MD, PhD; Fujii, Toshimitsu MD, PhD; Morio, Junko MD, PhD; Saito, Eiko MD, PhD; Watanabe, Mamoru MD, PhD

doi: 10.1002/ibd.23027
Original Clinical Articles

Background: Few studies have measured the levels of antibodies specific for measles, mumps, rubella, and varicella zoster/chickenpox viruses in inflammatory bowel disease (IBD) patients undergoing treatment with immunomodulators/biologics.

Methods: We prospectively recruited 139 IBD outpatients. Enzyme-linked immunosorbent assays were used as the serological tests for measles, mumps, rubella, and varicella zoster. We defined anti-rubella IgG < 10 IU/mL, anti-measles IgG < 16 IU/mL, and anti-mumps/varicella zoster IgG <4 IU/mL as seronegative for viruses. We also asked participants about past immunizations against or infections with measles, mumps, rubella, and varicella zoster viruses.

Results: The proportion of patients with seronegative levels of antibodies specific for varicella zoster, rubella, measles, and mumps viruses was 5%, 30%, 34%, and 37%, respectively. Approximately 40% of the IBD patients did not remember whether they had previously been infected with any of the viruses, and almost one-third of the patients could not remember whether they had previously been vaccinated. Almost 30% of the patients with a past history of rubella or measles did not have seropositive antibody levels. A total of 54% of the patients being treated with immunosuppressant displayed seronegative levels of antibodies specific for at least one of the viruses.

Conclusions: Many IBD patients were unaware of whether they had previously been vaccinated against or infected with the viruses causing varicella zoster, rubella, measles, or mumps. Therefore, measuring the current levels of antibodies specific for such viruses is useful for determining whether patients have seropositive antibody levels before immunomodulators/biologics are used for therapy.

Article first published online 17 May 2012

Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan.

Current address for M. Naganuma: Department of Gastroenterology and Hepatology, Keio University, Tokyo, Japan.

Reprints: Makoto Naganuma, MD, PhD, Department of Gastroenterology and Hepatology, School of Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan (e-mail: mnaganuma.gast@tmd.ac.jp).

Supported in part by Health and Labor Sciences Research Grants for research on intractable diseases from the Ministry of Health, Labor and Welfare of Japan.

Received May 1, 2012

Accepted May 3, 2012

© Crohn's & Colitis Foundation of America, Inc.
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