Giuseppe
Emeritus
[Source: PLoS ONE, full text: (LINK). Abstract, edited.]
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Immunogenicity and Acceptance of Influenza A (H1N1) Vaccine in a Cohort of Chronic Hepatitis C Patients Receiving Pegylated-Interferon Treatment
Manuel Hern?ndez-Guerra<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP><SUP>*</SUP>, Yanira Gonz?lez-M?ndez<SUP>1</SUP>, Patricia de Molina<SUP>3</SUP>, Antonio Z. Gimeno-Garc?a<SUP>1</SUP>, Marta Carrillo<SUP>1</SUP>, Carlos Casanova<SUP>1</SUP>, Tom?s Pumarola<SUP>3</SUP><SUP>,</SUP><SUP>4</SUP>, Alejandro Jimenez<SUP>2</SUP>, Miriam Hern?ndez-Porto<SUP>5</SUP>, ?lvaro Torres<SUP>5</SUP>, Enrique Quintero<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP>
<SUP></SUP>
1 Liver Unit, University Hospital of the Canary Islands, Tenerife, Spain, 2 Research Unit, University Hospital of the Canary Islands, Tenerife, Spain, 3 Barcelona Centre for International Health Research (CRESIB), Hospital Cl?nic-Universitat de Barcelona, Barcelona, Spain, 4 Department of Clinical Microbiology, Hospital Cl?nic, School of Medicine, University of Barcelona, Barcelona, Spain, 5 Preventive Medicine and Public Health Department, University of La Laguna, Tenerife, Spain
Abstract
Background & Aims
Individuals at risk of (H1N1) influenza A infection are recommended to receive vaccination. Chronic hepatitis C (CHC) patients receiving treatment might be at a higher risk of respiratory bacterial infections after influenza infection. However, there are no observational studies evaluating the immunogenicity, tolerance and acceptance of 2009 influenza A vaccine in CHC patients.
Methods
We evaluated the immunogenicity of influenza A vaccine (Pandemrix?) by using the hemagglutination inhibition (HI) titers method in a well defined cohort of CHC patients receiving or not receiving pegylated-interferon and ribavirin, and compared it with healthy subjects (controls). A group of patients with inflammatory bowel disease (IBD) under immunosuppression, thought to have a lower immune response to seasonal influenza vaccine, were also included as a negative control group. In addition, tolerance to injection site reactions and acceptance was assessed by a validated questionnaire (Vaccinees' perception of injection-VAPI-questionnaire).
Results
Of 114 subjects invited to participate, 68% accepted and, after exclusions, 72 were included. Post-vaccination geometric mean titers and seroprotection/seroconversion rates were optimal in CHC patients with ongoing treatment (n = 15; 232, CI95% 46?1166; 93%; 93%), without treatment (n = 10; 226, CI95% 69?743: 100%; 100%) and controls (n = 15;168, CI95% 42?680; 93%; 86%) with no differences between groups (P = 0.8). In contrast, IBD patients had a significantly lower immunogenic response (n = 27; 60, CI95% 42?680;66%;66%; P = 0.006). All the groups showed a satisfactory tolerance although CHC patients with ongoing treatment showed more local discomfort after vaccine injection.
Conclusion
There appeared to be no differences between CHC patients and healthy controls in serological response and acceptance of (H1N1) influenza vaccination.
Citation: Hern?ndez-Guerra M, Gonz?lez-M?ndez Y, de Molina P, Gimeno-Garc?a AZ, Carrillo M, et al. (2012) Immunogenicity and Acceptance of Influenza A (H1N1) Vaccine in a Cohort of Chronic Hepatitis C Patients Receiving Pegylated-Interferon Treatment. PLoS ONE 7(11): e48610. doi:10.1371/journal.pone.0048610
Editor: Golo Ahlenstiel, University of Sydney, Australia
Received: May 23, 2012; Accepted: September 27, 2012; Published: November 8, 2012
Copyright: ? 2012 Hern?ndez-Guerra et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: This study has been supported in part by grants from Fonds Europ?en de D?veloppement R?gional (FEDER). Dr. M. Hern?ndez-Guerra is the recipient of a grant from Instituto de Salud Carlos III (538/07) and Programa de Intensificaci?n de Actividad Investigadora (INT07/173). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
* E-mail: mhernandezguerra@gmail.com
-Manuel Hern?ndez-Guerra<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP><SUP>*</SUP>, Yanira Gonz?lez-M?ndez<SUP>1</SUP>, Patricia de Molina<SUP>3</SUP>, Antonio Z. Gimeno-Garc?a<SUP>1</SUP>, Marta Carrillo<SUP>1</SUP>, Carlos Casanova<SUP>1</SUP>, Tom?s Pumarola<SUP>3</SUP><SUP>,</SUP><SUP>4</SUP>, Alejandro Jimenez<SUP>2</SUP>, Miriam Hern?ndez-Porto<SUP>5</SUP>, ?lvaro Torres<SUP>5</SUP>, Enrique Quintero<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP>
<SUP></SUP>
1 Liver Unit, University Hospital of the Canary Islands, Tenerife, Spain, 2 Research Unit, University Hospital of the Canary Islands, Tenerife, Spain, 3 Barcelona Centre for International Health Research (CRESIB), Hospital Cl?nic-Universitat de Barcelona, Barcelona, Spain, 4 Department of Clinical Microbiology, Hospital Cl?nic, School of Medicine, University of Barcelona, Barcelona, Spain, 5 Preventive Medicine and Public Health Department, University of La Laguna, Tenerife, Spain
Abstract
Background & Aims
Individuals at risk of (H1N1) influenza A infection are recommended to receive vaccination. Chronic hepatitis C (CHC) patients receiving treatment might be at a higher risk of respiratory bacterial infections after influenza infection. However, there are no observational studies evaluating the immunogenicity, tolerance and acceptance of 2009 influenza A vaccine in CHC patients.
Methods
We evaluated the immunogenicity of influenza A vaccine (Pandemrix?) by using the hemagglutination inhibition (HI) titers method in a well defined cohort of CHC patients receiving or not receiving pegylated-interferon and ribavirin, and compared it with healthy subjects (controls). A group of patients with inflammatory bowel disease (IBD) under immunosuppression, thought to have a lower immune response to seasonal influenza vaccine, were also included as a negative control group. In addition, tolerance to injection site reactions and acceptance was assessed by a validated questionnaire (Vaccinees' perception of injection-VAPI-questionnaire).
Results
Of 114 subjects invited to participate, 68% accepted and, after exclusions, 72 were included. Post-vaccination geometric mean titers and seroprotection/seroconversion rates were optimal in CHC patients with ongoing treatment (n = 15; 232, CI95% 46?1166; 93%; 93%), without treatment (n = 10; 226, CI95% 69?743: 100%; 100%) and controls (n = 15;168, CI95% 42?680; 93%; 86%) with no differences between groups (P = 0.8). In contrast, IBD patients had a significantly lower immunogenic response (n = 27; 60, CI95% 42?680;66%;66%; P = 0.006). All the groups showed a satisfactory tolerance although CHC patients with ongoing treatment showed more local discomfort after vaccine injection.
Conclusion
There appeared to be no differences between CHC patients and healthy controls in serological response and acceptance of (H1N1) influenza vaccination.
Citation: Hern?ndez-Guerra M, Gonz?lez-M?ndez Y, de Molina P, Gimeno-Garc?a AZ, Carrillo M, et al. (2012) Immunogenicity and Acceptance of Influenza A (H1N1) Vaccine in a Cohort of Chronic Hepatitis C Patients Receiving Pegylated-Interferon Treatment. PLoS ONE 7(11): e48610. doi:10.1371/journal.pone.0048610
Editor: Golo Ahlenstiel, University of Sydney, Australia
Received: May 23, 2012; Accepted: September 27, 2012; Published: November 8, 2012
Copyright: ? 2012 Hern?ndez-Guerra et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: This study has been supported in part by grants from Fonds Europ?en de D?veloppement R?gional (FEDER). Dr. M. Hern?ndez-Guerra is the recipient of a grant from Instituto de Salud Carlos III (538/07) and Programa de Intensificaci?n de Actividad Investigadora (INT07/173). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
* E-mail: mhernandezguerra@gmail.com
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