Infection prevention in patients with hereditary hemorrhagic telangiectasia

After reading the manuscript by Kritharis A et al., with interest we agree that the prevention of future hereditary hemorrhagic telangiectasia (HHT) complications is as important as treating the immediate active issues.1 For this reason, we would like to add an important part of the management of these patients that Kritharis A et al. did not mention in their manuscript, which is the prevention of severe infections through vaccination.2

Patients with HHT have an increased risk of infection potentially leading to serious infections requiring hospitalization, which according to the series is between 13.6% and 28.6% of the cases.43 This increased risk is mainly due to the following:

For these reasons, we consider that vaccination protocols should be implemented in the management of patients affected by HHT,8 along with adequate oral hygiene and antibiotic prophylaxis prior to risky dental maneuvers. As previously mentioned,2 we propose the vaccination protocol for patients with HHT shown in Table 1.

Table 1.Vaccination protocol of the patient with hereditary hemorrhagic telangiectasia.