CDC reports rise in meningococcal disease among people with HIV
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Key takeaways:
- The CDC has recommended two doses of meningococcal vaccine for people with HIV since 2016.
- Despite the recommendation, cases of meningococcal disease spiked in 2022.
Prompted by a large spike in cases last year, the CDC has reminded health care providers to ensure that all patients with HIV are fully vaccinated against meningococcal disease.
Although the CDC has recommended since 2016 that people with HIV receive two doses of the MenACWY vaccine, coverage remains low, Amy Rubis, MPH, and CDC colleagues reported Thursday in MMWR.
According to the new report, nearly one in 10 cases of meningococcal disease recorded in the United States in 2022 occurred among people with HIV — more than double the proportion in any of the previous 5 years.
The finding was based on preliminary data from the national notifiable disease surveillance system and additional information from enhanced meningococcal disease surveillance, which showed that 29 people with HIV were diagnosed with meningococcal disease last year — 9.8% of all U.S. cases.
In the previous 5 years, five to 15 cases were reported among people with HIV, representing 1.5% to 4.3% of all cases.
The number of cases diagnosed in 2022 could still increase when reporting is complete, the researchers wrote. Almost all the cases — 28 of 29 — occurred among people who were unvaccinated or whose vaccination history was unknown. One person was vaccinated, although it was unknown whether they had received both doses.
This is the second time in less than a year that the CDC is reminding people with HIV about the importance of being vaccinated against meningococcal disease. Last June, the agency urged gay and bisexual men living in Florida to get vaccinated amid a large and deadly outbreak of the disease.
Even without including cases associated with the outbreak, there still would have been a substantial increase in meningococcal disease among people with HIV last year, Rubis and colleagues wrote.
Among 14 cases not related to the outbreak, nine were caused by one strain of Neisseria meningitidis serogroup Y and occurred in three states, with no identified connections, the researchers reported. Eight of those patients were Black or African American, and seven were men who have sex with men.
“[G]iven the recent increase in meningococcal disease cases in this population, health care providers should ensure that all persons with HIV are up to date with MenACWY vaccination ... as well as other vaccines recommended for this population,” the researchers wrote. “Health care providers should also maintain a high index of suspicion for meningococcal disease among persons with HIV who have symptoms of meningococcal disease.”
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