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En este grupo se incluyen la enfermedad Inflamatoria Intestinal (EII), artropat\u00edas inflamatorias y tambi\u00e9n determinadas condiciones dermatol\u00f3gicas inflamatorias. En este apartado se tratar\u00e1n las recomendaciones en EII (enfermedad de Crohn y colitis ulcerosa) y artropat\u00edas inflamatorias (lupus eritematoso sist\u00e9mico \u2013LES-, artritis reumatoide o juvenil, etc.), en las que las infecciones inmunoprevenibles causan importante morbilidad y mortalidad.<\/p>\n
La enfermedad de Crohn (EC) y la colitis ulcerosa (CU) se caracterizan por la inflamaci\u00f3n cr\u00f3nica del tracto gastrointestinal. Se postula que factores gen\u00e9ticos y ambientales llevan a la alteraci\u00f3n de la flora intestinal con la consiguiente desregulaci\u00f3n de la inmunidad intestinal.<\/p>\n
Entre las enfermedades reum\u00e1ticas se encuentran las articulares (artritis reumatoide, osteoartritis, artritis reumatoide juvenil) y las del tejido conectivo (LES). Suelen ser progresivas y en todas ellas subyace una alteraci\u00f3n de la respuesta inmune e inflamatoria. Se estima una prevalencia mundial de m\u00e1s de 14 millones de casos solo de la artritis reumatoide, con unas 26.500 muertes anuales en 2015. Para el total de enfermedades reum\u00e1ticas se estima una prevalencia en el 2015 de m\u00e1s de mil millones de casos a nivel mundial, con casi 80.000 muertes.<\/p>\n
El riesgo de enfermedades inmunoprevenibles en las personas con enfermedades inflamatorias se debe tanto a una respuesta alterada del sistema inmune como a la posible malnutrici\u00f3n (en EII) y a la inmunosupresi\u00f3n ocasionada por los tratamientos espec\u00edficos utilizados, as\u00ed como por otras patolog\u00edas asociadas. Es importante tener en cuenta que las recomendaciones de vacunaci\u00f3n dependen del grado de inmunosupresi\u00f3n por la enfermedad o por el tipo de tratamiento administrado.<\/p>\n
Se debe vacunar antes de iniciar tratamiento inmunosupresor para conseguir una \u00f3ptima respuesta inmune. En general, las personas en tratamiento con inmunosupresores deben estar vacunadas frente a sarampi\u00f3n, rub\u00e9ola, parotiditis (triple v\u00edrica), varicela, t\u00e9tanos y difteria, neumococo y vacunaci\u00f3n anual frente a la gripe.<\/p>\n
Las personas con estas enfermedades no tratadas con f\u00e1rmacos inmunosupresores, o en tratamiento con inmunomoduladores a dosis no inmunosupresoras, se consideran inmunocompetentes y deben recibir las vacunas recomendadas en poblaci\u00f3n general.<\/p>\n
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Se realizar\u00e1n marcadores de infecci\u00f3n, preferiblemente pretratamiento, en caso de no disponer de documentaci\u00f3n de haber recibido dos dosis de vacuna. En caso de negatividad, se administrar\u00e1 una o dos dosis de vacuna triple v\u00edrica (seg\u00fan las recibidas previamente) al menos cuatro semanas antes de iniciar el tratamiento. Si se encuentra en tratamiento inmunosupresor, esperar al menos tres meses despu\u00e9s de finalizado. No es necesaria la serolog\u00eda posterior.<\/p>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=\u00bb1″ admin_label=\u00bbPopup – #2″ module_id=\u00bb2″ module_class=\u00bbpopup\u00bb _builder_version=\u00bb4.20.0″ _module_preset=\u00bbdefault\u00bb background_color=\u00bbrgba(37,163,156,0.34)\u00bb width=\u00bb66%\u00bb max_width=\u00bb66%\u00bb hover_enabled=\u00bb0″ da_is_popup=\u00bbon\u00bb da_popup_slug=\u00bb2″ da_disable_devices=\u00bboff|off|off\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″ da_exit_intent=\u00bboff\u00bb da_has_close=\u00bbon\u00bb da_alt_close=\u00bboff\u00bb da_dark_close=\u00bboff\u00bb da_not_modal=\u00bbon\u00bb da_is_singular=\u00bboff\u00bb da_with_loader=\u00bboff\u00bb da_has_shadow=\u00bbon\u00bb][et_pb_row _builder_version=\u00bb4.19.5″ _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb][et_pb_column type=\u00bb4_4″ _builder_version=\u00bb4.19.5″ _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb][et_pb_text _builder_version=\u00bb4.20.0″ _module_preset=\u00bbdefault\u00bb link_font=\u00bb||||on||||\u00bb link_text_color=\u00bb#00857C\u00bb header_2_font=\u00bb|||on|||||\u00bb header_2_text_color=\u00bb#00857C\u00bb background_color=\u00bb#FFFFFF\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb hover_enabled=\u00bb0″ border_radii=\u00bbon|6px|6px|6px|6px\u00bb border_width_left=\u00bb5px\u00bb border_color_left=\u00bb#05A29B\u00bb box_shadow_style=\u00bbpreset2″ global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″]<\/p>\n
Se realizar\u00e1 serolog\u00eda espec\u00edfica pretratamiento incluso en el caso de que sean positivos los antecedentes de padecimiento previo, no siendo necesaria si con anterioridad se han recibido dos dosis de vacuna. Si es negativa, recibir\u00e1 una o dos dosis (seg\u00fan las recibidas previamente) al menos cuatro semanas antes de iniciar el tratamiento. Si se encuentra en tratamiento inmunosupresor, esperar al menos tres meses despu\u00e9s de finalizado. No es necesaria la serolog\u00eda posterior.<\/p>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=\u00bb1″ admin_label=\u00bbPopup – #3″ module_id=\u00bb3″ module_class=\u00bbpopup\u00bb _builder_version=\u00bb4.20.0″ _module_preset=\u00bbdefault\u00bb background_color=\u00bbrgba(37,163,156,0.34)\u00bb width=\u00bb66%\u00bb max_width=\u00bb66%\u00bb hover_enabled=\u00bb0″ da_is_popup=\u00bbon\u00bb da_popup_slug=\u00bb3″ da_disable_devices=\u00bboff|off|off\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″ da_exit_intent=\u00bboff\u00bb da_has_close=\u00bbon\u00bb da_alt_close=\u00bboff\u00bb da_dark_close=\u00bboff\u00bb da_not_modal=\u00bbon\u00bb da_is_singular=\u00bboff\u00bb da_with_loader=\u00bboff\u00bb da_has_shadow=\u00bbon\u00bb][et_pb_row _builder_version=\u00bb4.19.5″ _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb][et_pb_column type=\u00bb4_4″ _builder_version=\u00bb4.19.5″ _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb][et_pb_text _builder_version=\u00bb4.20.0″ _module_preset=\u00bbdefault\u00bb link_font=\u00bb||||on||||\u00bb link_text_color=\u00bb#00857C\u00bb header_2_font=\u00bb|||on|||||\u00bb header_2_text_color=\u00bb#00857C\u00bb background_color=\u00bb#FFFFFF\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb hover_enabled=\u00bb0″ border_radii=\u00bbon|6px|6px|6px|6px\u00bb border_width_left=\u00bb5px\u00bb border_color_left=\u00bb#05A29B\u00bb box_shadow_style=\u00bbpreset2″ global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″]<\/p>\n
Solo se recomienda en quienes presentan riesgo elevado de infecci\u00f3n y tras realizar estudio serol\u00f3gico (AgHBs, anti-HBs y anti-HBc).<\/p>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=\u00bb1″ admin_label=\u00bbPopup – #4″ module_id=\u00bb4″ module_class=\u00bbpopup\u00bb _builder_version=\u00bb4.20.0″ _module_preset=\u00bbdefault\u00bb background_color=\u00bbrgba(37,163,156,0.34)\u00bb width=\u00bb66%\u00bb max_width=\u00bb66%\u00bb hover_enabled=\u00bb0″ da_is_popup=\u00bbon\u00bb da_popup_slug=\u00bb4″ da_disable_devices=\u00bboff|off|off\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″ da_exit_intent=\u00bboff\u00bb da_has_close=\u00bbon\u00bb da_alt_close=\u00bboff\u00bb da_dark_close=\u00bboff\u00bb da_not_modal=\u00bbon\u00bb da_is_singular=\u00bboff\u00bb da_with_loader=\u00bboff\u00bb da_has_shadow=\u00bbon\u00bb][et_pb_row _builder_version=\u00bb4.19.5″ _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb][et_pb_column type=\u00bb4_4″ _builder_version=\u00bb4.19.5″ _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb][et_pb_text _builder_version=\u00bb4.20.0″ _module_preset=\u00bbdefault\u00bb link_font=\u00bb||||on||||\u00bb link_text_color=\u00bb#00857C\u00bb header_2_font=\u00bb|||on|||||\u00bb header_2_text_color=\u00bb#00857C\u00bb background_color=\u00bb#FFFFFF\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb hover_enabled=\u00bb0″ border_radii=\u00bbon|6px|6px|6px|6px\u00bb border_width_left=\u00bb5px\u00bb border_color_left=\u00bb#05A29B\u00bb box_shadow_style=\u00bbpreset2″ global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″]<\/p>\n
En caso de presentar inmunosupresi\u00f3n se administrar\u00e1 pauta secuencial (VNC13+VNP23) con intervalo de separaci\u00f3n recomendado entre dosis de 12 meses (m\u00ednimo de 8 semanas).<\/p>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=\u00bb1″ admin_label=\u00bbPopup – #5″ module_id=\u00bb5″ module_class=\u00bbpopup\u00bb _builder_version=\u00bb4.20.0″ _module_preset=\u00bbdefault\u00bb background_color=\u00bbrgba(37,163,156,0.34)\u00bb width=\u00bb66%\u00bb max_width=\u00bb66%\u00bb hover_enabled=\u00bb0″ da_is_popup=\u00bbon\u00bb da_popup_slug=\u00bb5″ da_disable_devices=\u00bboff|off|off\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″ da_exit_intent=\u00bboff\u00bb da_has_close=\u00bbon\u00bb da_alt_close=\u00bboff\u00bb da_dark_close=\u00bboff\u00bb da_not_modal=\u00bbon\u00bb da_is_singular=\u00bboff\u00bb da_with_loader=\u00bboff\u00bb da_has_shadow=\u00bbon\u00bb][et_pb_row _builder_version=\u00bb4.19.5″ _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb][et_pb_column type=\u00bb4_4″ _builder_version=\u00bb4.19.5″ _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb][et_pb_text _builder_version=\u00bb4.20.0″ _module_preset=\u00bbdefault\u00bb link_font=\u00bb||||on||||\u00bb link_text_color=\u00bb#00857C\u00bb header_2_font=\u00bb|||on|||||\u00bb header_2_text_color=\u00bb#00857C\u00bb background_color=\u00bb#FFFFFF\u00bb custom_padding=\u00bb20px|20px|20px|20px|true|true\u00bb hover_enabled=\u00bb0″ border_radii=\u00bbon|6px|6px|6px|6px\u00bb border_width_left=\u00bb5px\u00bb border_color_left=\u00bb#05A29B\u00bb box_shadow_style=\u00bbpreset2″ global_colors_info=\u00bb{}\u00bb theme_builder_area=\u00bbpost_content\u00bb sticky_enabled=\u00bb0″]<\/p>\n
Se recomienda la vacunaci\u00f3n anual.<\/p>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"
Enfermedades inflamatorias cr\u00f3nicasExplicaci\u00f3nRecomendaciones espec\u00edficas de vacunaci\u00f3n