Influenza Other Respi Viruses. 2012 Oct 19. doi: 10.1111/irv.12024. [Epub ahead of print]
Influence of renal replacement therapy on immune response after one and two doses of the A(H1N1) pdm09 vaccine.
Quintana LF, Serra N, De Molina-Llaurad? P, Blasco M, Martinez M, Campos B, Bayas JM, Pumarola T, Campistol JM.
Source
Department of Nephrology and Renal Transplantation, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain. Department of Clinical Microbiology, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain. Barcelona Centre for International Health Research (CRESIB), Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain. Biostatistics Unit, Department of Public Health, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain. Preventive Medicine and Epidemiology Unit Hospital Cl?nic de Barcelona, IDIBAPS, University de Barcelona, Barcelona, Spain.
Abstract
Please cite this paper as: Quintana et al. (2012) Influence of renal replacement therapy on immune response after one and two doses of the A(H1N1) pdm09 vaccine. Influenza and Other Respiratory Viruses DOI: 10.1111/irv.12024. Background Patients with end-stage renal disease have a reduced response to vaccination because of the general suppression of the immune system associated with uraemia. Objectives We evaluated the immune response and differential factors in the immunogenecity to an adjuvanted A(H1N1) pdm09 vaccine (Pandemrix(?) ) in four populations of renal patients after one and two doses of vaccine. Patients Methods 151 patients were included in this study: 58 chronic haemodialysis patients, 52 renal allograft recipients, 14 peritoneal dialysis patients and 27 patients with advanced chronic kidney disease in preparation for kidney replacement therapy. Influenza-specific antibody levels were measured by monitoring A(H1N1) pdm09 titres using a haemagglutination inhibition assay. Results The seroconversion rate at 42 days after two vaccine doses was 80% in the haemodialysis group, 64?9% in the renal allograft recipients group, 100% in the advanced chronic kidney disease group and 71?4% in the peritoneal dialysis group (P = 0?041). Conclusions Immune response to two doses of the influenza A H1N1 vaccine is dissimilar in the four renal conditions, confirming that seroprotection in pre-dialysis, haemodialysis and peritoneal dialysis is similar to that in the general population vaccinated with one dose. In contrast, renal transplant recipients with good allograft function showed inadequate protection and triple immunosuppressive therapy including calcineurin inhibitors, mycophenolate and steroids negatively influenced seroconversion after vaccination in renal recipients.
? 2012 Blackwell Publishing Ltd.
PMID:
23078139
[PubMed - as supplied by publisher]
Influence of renal replacement therapy on immune response after one and two doses of the A(H1N1) pdm09 vaccine.
Quintana LF, Serra N, De Molina-Llaurad? P, Blasco M, Martinez M, Campos B, Bayas JM, Pumarola T, Campistol JM.
Source
Department of Nephrology and Renal Transplantation, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain. Department of Clinical Microbiology, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain. Barcelona Centre for International Health Research (CRESIB), Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain. Biostatistics Unit, Department of Public Health, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain. Preventive Medicine and Epidemiology Unit Hospital Cl?nic de Barcelona, IDIBAPS, University de Barcelona, Barcelona, Spain.
Abstract
Please cite this paper as: Quintana et al. (2012) Influence of renal replacement therapy on immune response after one and two doses of the A(H1N1) pdm09 vaccine. Influenza and Other Respiratory Viruses DOI: 10.1111/irv.12024. Background Patients with end-stage renal disease have a reduced response to vaccination because of the general suppression of the immune system associated with uraemia. Objectives We evaluated the immune response and differential factors in the immunogenecity to an adjuvanted A(H1N1) pdm09 vaccine (Pandemrix(?) ) in four populations of renal patients after one and two doses of vaccine. Patients Methods 151 patients were included in this study: 58 chronic haemodialysis patients, 52 renal allograft recipients, 14 peritoneal dialysis patients and 27 patients with advanced chronic kidney disease in preparation for kidney replacement therapy. Influenza-specific antibody levels were measured by monitoring A(H1N1) pdm09 titres using a haemagglutination inhibition assay. Results The seroconversion rate at 42 days after two vaccine doses was 80% in the haemodialysis group, 64?9% in the renal allograft recipients group, 100% in the advanced chronic kidney disease group and 71?4% in the peritoneal dialysis group (P = 0?041). Conclusions Immune response to two doses of the influenza A H1N1 vaccine is dissimilar in the four renal conditions, confirming that seroprotection in pre-dialysis, haemodialysis and peritoneal dialysis is similar to that in the general population vaccinated with one dose. In contrast, renal transplant recipients with good allograft function showed inadequate protection and triple immunosuppressive therapy including calcineurin inhibitors, mycophenolate and steroids negatively influenced seroconversion after vaccination in renal recipients.
? 2012 Blackwell Publishing Ltd.
PMID:
23078139
[PubMed - as supplied by publisher]