Advising the immunocompromised traveller: a review of immunocompromise at The London Hospital for Tropical Diseases Travel Clinic between 1st April 2019 and 30th April 2020

Table 3 Mildly immunocompromised travellers

Severity	Reason for Immunocompromise	Core condition/state		Immunosuppressive medication or treatment	Patients (n)
Mild (n = 145)	Physiological	Pregnancy [23, 47, 48]		NA	36	81
		Age ≥ 60 [49, 50]			34
		Age ≤ 2 [22]			11
	Chronic Infectious Condition	HIV [19]	CD4 ≥ 500mm³	NA	26	33
		HIV [19]	CD4 ≥ 200 < 500 mm [3]	NA	5
		Infectious liver disease	Cirrhosis, chronic hepatitis B	NA	1
		Infectious liver disease	Partial liver secondary to parasitic cyst removal, disseminated candida	NA	1
	Chronic metabolic condition	Diabetes mellitus [22]		NA	13	13
	Malignancy	Solid cancer	Neuroendocrine tumour, with liver metastases	Radiotherapy < 12 months ago (localised radiotherapy) *	1	1
	Immune modulated conditions on low dose immunosuppression	Bilateral uveitis		Low dose prednisolone < 20 mg/day [18]	1	10
		Psoriasis		Low dose oral methotrexate < 25 mg weekly [18]	1
		Rheumatoid arthritis			2
		Systemic lupus erythematous			1
		Crohn’s disease		Low dose azathioprine < 3 mg/Kg/day [18]	1
		PFAPA syndrome		Low dose azathioprine < 3 mg/Kg/day [18]	1
		Birdshot uveitis		Low dose MMF ≤ 1 g a day [18]	1
		Dermatomyositis		azathioprine < 3 mg/Kg/day and prednisolone < 20 mg/day	1
		Multiple sclerosis [7]		Interferon beta-1α injections	1
	Hyposplenia	Sickle cell disease [7]		Hydroxycarbamide	3	7
		Sickle cell disease [7]		No treatment	3
		Coeliac disease		NA	1

Abbreviations: HIV, human immunodeficiency virus; MMF, mycophenolate mofetil; NA, not applicable; PFAPA, Periodic Fever, Aphthous Stomatitis, Pharyngitis, Adenitis. *CDC suggests severe IC only if “recent”, Green book suggests severe if radiotherapy < 6 months ago therefore we categorised as mild

ISSN: 2055-0936