One in 40 Americans Immunosuppressed

By Will Boggs MD

NEW YORK (Reuters Health) - About 2.7% of U.S. adults are immunosuppressed, according to results from the 2013 National Health Interview Survey (NHIS).

"Given the rapidly growing numbers of indications for immunosuppressive treatments and the generally increasing life expectancy for immunosuppressed patients, physicians are likely to regularly be seeing immunosuppressed patients, and the number of these patients may be increasing over time," said Dr. Rafael Harpaz from Centers for Disease Control and Prevention in Atlanta, Georgia.

"Physicians need to be mindful of the unique features of these patients in terms of disease diagnoses and management, as well as their special counseling and prevention requirements," he told Reuters Health by email.

Dr. Harpaz and colleagues, whose findings were published online October 28 in JAMA, used NHIS data to estimate the prevalence of self-reported immunosuppressed adults in the U.S.

"Our biggest surprise regarding this issue is the fact that no one has gathered any data on this important phenomenon in the past," he said.

Of more than 34,000 adult respondents, 4.2% had been told at some time by a health professional that their immune system was weakened, including 2.8% who reported current immunosuppression and additional evidence of immunosuppression.

These findings translate to an estimated U.S. prevalence of 2.7% (range, 1.8% to 3.1% in sensitivity analyses), according to the researchers.

The prevalence of immunosuppression was highest among women, whites, and persons aged 50 to 59 years.

The study was not designed to identify the causes of immunosuppression.

"There are many phase 2 and phase 3 trials currently underway studying immunosuppressive treatments to prevent or control a wide assortment of common chronic diseases, such as cardiovascular disease, type 2 diabetes type, and even depression," Dr. Harpaz said. "If these trials are successful, rates of immunosuppression are likely to increase in the future."

"The prevalence of immunosuppression needs to be on the radar screen of physicians and public health practitioners," he concluded. "Our study is a call for additional data and ongoing tracking of this phenomenon."

SOURCE: https://bit.ly/2e91keY

JAMA 2016.

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