tetano
Editor, Senior Moderator
Transplantation. 2012 Aug 14. [Epub ahead of print]
Impact of Anti-T-Cell Therapy in the Immunogenicity of Seasonal Influenza Vaccine in Kidney Transplant Recipients.
Orcurto A, Pascual M, Hoschler K, Aubert V, Meylan P, Manuel O.
Source
1 Transplantation Center, University Hospital and University of Lausanne, Switzerland. 2 Infectious Diseases Service, University Hospital and University of Lausanne, Switzerland. 3 Health Protection Agency, London, UK. 4 Division of Immunology and Allergy, University Hospital and University of Lausanne, Switzerland. 5 Institute of Microbiology, University Hospital and University of Lausanne, Switzerland. 6 Address correspondence to: Oriol Manuel M.D., Infectious Diseases Service, University Hospital and University of Lausanne, BH08-652, Lausanne, Switzerland.
Abstract
BACKGROUND:
The influence of anti-T-cell therapy in the immunogenicity of the influenza vaccine in kidney transplant recipients remains unclear.
METHODS:
During the 2010 to 2011 influenza season, we evaluated the immune response to the inactivated trivalent influenza vaccine in kidney transplant recipients having received Thymoglobulin or basiliximab as induction therapy. A hemagglutination inhibition assay was used to assess the immunogenicity of the vaccine. The primary outcome was geometric mean titers of hemagglutination inhibition after influenza vaccination.
RESULTS:
Sixty patients (Thymoglobulin n=22 and basiliximab n=38) were included. Patients in the Thymoglobulin group were older (P=0.16), showed higher creatinine levels (P=0.16) and had more frequently received a previous transplant (P=0.02). There were no significant differences in geometric mean titers for any of the three viral strains between groups (P=0.69 for H1N1, P=0.56 for H3N2, and P=0.7 for B strain). Seroconversion to at least one viral strain was seen in 15 (68%) of 22 patients in the Thymoglobulin group and 28 (73%) of 38 in the basiliximab group (P=0.77). In patients vaccinated during the first year after receiving anti-T-cell therapy (n=25), there was a trend toward lower vaccine responses in the Thymoglobulin group. Patients who received Thymoglobulin showed lower CD4 cell counts and lower levels of IgM, at an average of 16.2 months after transplantation. A multivariate analysis showed that only the absence of mycophenolate was associated with a better vaccine response (odds ratio=9.47; 95% confidence interval, 1.03-86.9; P=0.047).
CONCLUSION:
No significant differences were seen in immunogenicity of the influenza vaccine in kidney transplant recipients having received either Thymoglobulin or basiliximab.
PMID:
22895612
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22895612
Impact of Anti-T-Cell Therapy in the Immunogenicity of Seasonal Influenza Vaccine in Kidney Transplant Recipients.
Orcurto A, Pascual M, Hoschler K, Aubert V, Meylan P, Manuel O.
Source
1 Transplantation Center, University Hospital and University of Lausanne, Switzerland. 2 Infectious Diseases Service, University Hospital and University of Lausanne, Switzerland. 3 Health Protection Agency, London, UK. 4 Division of Immunology and Allergy, University Hospital and University of Lausanne, Switzerland. 5 Institute of Microbiology, University Hospital and University of Lausanne, Switzerland. 6 Address correspondence to: Oriol Manuel M.D., Infectious Diseases Service, University Hospital and University of Lausanne, BH08-652, Lausanne, Switzerland.
Abstract
BACKGROUND:
The influence of anti-T-cell therapy in the immunogenicity of the influenza vaccine in kidney transplant recipients remains unclear.
METHODS:
During the 2010 to 2011 influenza season, we evaluated the immune response to the inactivated trivalent influenza vaccine in kidney transplant recipients having received Thymoglobulin or basiliximab as induction therapy. A hemagglutination inhibition assay was used to assess the immunogenicity of the vaccine. The primary outcome was geometric mean titers of hemagglutination inhibition after influenza vaccination.
RESULTS:
Sixty patients (Thymoglobulin n=22 and basiliximab n=38) were included. Patients in the Thymoglobulin group were older (P=0.16), showed higher creatinine levels (P=0.16) and had more frequently received a previous transplant (P=0.02). There were no significant differences in geometric mean titers for any of the three viral strains between groups (P=0.69 for H1N1, P=0.56 for H3N2, and P=0.7 for B strain). Seroconversion to at least one viral strain was seen in 15 (68%) of 22 patients in the Thymoglobulin group and 28 (73%) of 38 in the basiliximab group (P=0.77). In patients vaccinated during the first year after receiving anti-T-cell therapy (n=25), there was a trend toward lower vaccine responses in the Thymoglobulin group. Patients who received Thymoglobulin showed lower CD4 cell counts and lower levels of IgM, at an average of 16.2 months after transplantation. A multivariate analysis showed that only the absence of mycophenolate was associated with a better vaccine response (odds ratio=9.47; 95% confidence interval, 1.03-86.9; P=0.047).
CONCLUSION:
No significant differences were seen in immunogenicity of the influenza vaccine in kidney transplant recipients having received either Thymoglobulin or basiliximab.
PMID:
22895612
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22895612