November 01, 2016
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Nearly 3% of US adult population immunosuppressed

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CDC researchers estimated that the prevalence of immunosuppression among adults in the United States was 2.7% in 2013. The research, published in JAMA, has implications for food and water safety, tuberculosis control, vaccine programs, infection control strategies, outbreak preparedness, travel medicine and other aspects of public health, according to the researchers. 

“The number of immunosuppressed adults in the United States is unknown, but thought to be increasing because of both greater life expectancy among immunosuppressed adults due to improvements in medical management, as well as new indications for immunosuppressive treatments,” Rafael Harpaz, MD, MPH, of CDC’s division of viral diseases, and colleagues wrote. “Tracking immunosuppression over time is particularly important given the hundreds of clinical trials now under way to assess the use of immunosuppressive treatments for prevention or mitigation of common chronic diseases in highly prevalent risk groups.”

Harpaz and colleagues performed a cross-sectional analysis of 34,426 adults who participated in the 2013 National Health Interview Survey. They asked participants whether they had ever been told by a physician or health care professional that they had a weakened immune system. In the analysis, only those who reported using immunosuppressive treatments or having immunosuppressive medical conditions such as hematopoietic cancers or HIV were considered immunosuppressed.

According to the data, 4.2% of participants (n = 1,442) had been told by a health care professional at some point in their lives that their immune system was weakened. Among them, 2.8% (n = 951) said they were currently immunocompromised and reported additional evidence of immunosuppression, yielding an estimated prevalence of 2.7% (95% CI, 2.4-2.9). In a sensitivity analysis, the prevalence of immunosuppression ranged from 1.8% (95% CI, 1.6-2) to 3.1% (95% CI, 2.9-3.3). It was highest among women, white participants and those aged 50 to 59 years.  

“Age-specific immunosuppression increased with age, in parallel with the epidemiology of prevalent conditions that require immunosuppressive treatments, but it is unclear why it peaked at ages 50 to 59 years,” the researchers wrote.

They concluded that more data are needed to confirm their estimates and to determine the prevalence of immunosuppression in children and institutionalized adults and whether the proportion of immunosuppressed adults in 2013 reflect current prevalence rates. – by Stephanie Viguers

Disclosure: The researchers report no relevant financial disclosures.