EVALUACIÓN DE LA EVIDENCIA DE REINFECCIONES SEVERAS DE DENGUE: UN METAANÁLISIS DE LA RAMA PLACEBO EN ENSAYOS CLÍNICOS ALEATORIZADOS (#21630)
Objetivos
To evaluate the association between serologically confirmed prior dengue infection (DVC) and the subsequent risk of DVC, severe dengue (DS), dengue hospitalization (DHOSP), dengue-related death, and all-cause mortality.
Materiales y Métodos
A systematic review and meta-analysis were conducted following PRISMA guidelines. Studies were searched in PubMed, CINAHL, Medline, Cochrane Library, and Web of Science, including only phase III randomized clinical trials of vaccine efficacy with data on participants in the placebo groups and information on previous infections. Random-effects models were applied to calculate combined odds ratios (OR), and heterogeneity among studies was assessed.
Resultados
A total of four studies corresponding to three phase III clinical trials were included. Participants with prior infection had a lower likelihood of developing DVC during follow-up (OR: 0.85; 95% CI: [0.75; 0.98]; p=0.024) and the same risk of dengue hospitalization as those without prior dengue (OR: 1.18; 95% CI: [0.92; 1.53]; p=0.198). However, they had a higher rate of DS during follow-up (OR: 2.91; 95% CI: [1.23; 6.87]; p=0.015). No dengue-related deaths were observed in any of the clinical trials during follow-up.
Conclusiones
Prior dengue infection significantly reduces the risk of DVC and increases the risk of DS, although it does not significantly affect the risk of dengue hospitalization or dengue-related death during follow-up. The findings of this study highlight the need to reconsider the value of prior infection as an independent risk factor.
Tipo: Comunicaciones Libres
Palabras clave: dengue,metanalisis,vacuna,epidemiologia
Categorias: Infectología, Inmunología Clínica
Institución: Universidad del Hospital Italiano de Buenos Aires
Ciudad: Ciudad de Buenos Aires ,
País: Argentina
Autores