Influenza virus vaccination in kidney transplant recipients: serum antibody response to different immunosuppressive drugs

Salles, Mauro José Costa; Sens, Yvoty Alves dos Santos; Boas, Lucy dos Santos Vilas; Machado, Clarisse Martins

doi:10.1111/j.1399-0012.2009.01095.x

Cited by 73 publications

(70 citation statements)

References 29 publications

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“…Among RT patients, those receiving mycophenolic acid had a lower increase in Ab response than those receiving azathioprine. This observation is similar to previous reports pertaining to influenza vaccination (9,11,26). This work brings additional data supporting the safety of influenza vaccination in renal transplant recipients (8,33) and also documents that vaccination does not induce sensitization against HLA or MICA in dialyzed patients, who can become candidates for kidney transplantation.…”

Section: Discussionsupporting

confidence: 77%

“…As compared with seroconversion rates recorded previously with seasonal H1N1 vaccines, such as A/New Caledonia/20/99 (H1N1), the proportion of responders among our RT patients seems to be higher. Indeed, seroconversion was only 10% in a series of 66 RT patients (versus 58% in healthy controls, P Ͻ 0.001) in a French study (8) and 36% in a Brazilian uncontrolled study of 69 patients (11). However, one should keep in mind that with seasonal vaccines, people are likely to have been vaccinated previously and therefore may show less robust subsequent vaccine response.…”

Section: Discussionmentioning

confidence: 99%

“…Either a single dose of 3.75 g of adjuvanted or 15 g of nonadjuvanted vaccine resulted in sero-conversion in approximately 75% to 90% of healthy volunteers (6,7). In solid organ recipients (8)(9)(10)(11) and dialysis patients (12), the overall rate of seroconversion to the seasonal flu vaccine is in the range of 30% to 50%. The use of adjuvanted vaccine has raised concerns for immunocompromised patients, because of possible induction of allo-immune responses, such as anti-human histocompatibility leukocyte antigen (HLA) antibodies (Abs) or MHC class I-related chain A (MICA) Abs (13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

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Influenza A/H1N1 Vaccine in Patients Treated by Kidney Transplant or Dialysis

Broeders

Hombrouck²,

Lemy³

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives In 2009, the pandemic influenza A/H1N1 accounted for worldwide recommendations about vaccination. There are few data concerning the immunogenicity or the security of the adjuvanted-A/H1N1 vaccine in transplanted and hemodialyzed patients.Design, setting, participants, & measurements Sera from 21 controls, 53 hemodialyzed (HD) patients, and 111 renal transplant recipients (RT) were sampled before (T0) and 1 month after (T1) a single dose of Pandemrix® vaccine (GSK Biologicals, AS03-adjuvanted). We measured the neutralizing antibodies against A/H1N1/2009, the geometric mean (GM) titers, the GM titer ratios (T1/T0) with 95% confidence intervals, and the seroconversion rate (responders: Ն4-fold increase in titer). The HLA and MICA immunization was determined by Luminex technology. ResultsThe GM titer ratio was 38 (19 to 78), 9 (5 to 16), and 5 (3 to 6) for controls, HD patients, and RT patients, respectively (P Ͻ 0.001). The proportion of responders was 90%, 57%, and 44%, respectively (P Ͻ 0.001). In RT patients, the prevalence of histocompatibility leukocyte antigen (HLA) class I, histocompatibility leukocyte antigen class II, and MHC class I-related chain A immunization, was, respectively, 15%, 14%, and 14% before and 14%, 14%, and 11% after vaccination (P ϭ 1, 1, and 0.39). ConclusionsThe influenza A/H1N1-adjuvanted vaccine is of limited efficacy but is safe in renal disease populations. The humoral response is lower in transplanted versus hemodialyzed patients. Further studies are needed to improve the efficacy of vaccination in those populations.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Influenza A/H1N1 Vaccine in Patients Treated by Kidney Transplant or Dialysis

Broeders

Hombrouck²,

Lemy³

et al. 2011

Clinical Journal of the American Society of Nephrology

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“…Traditional influenza A vaccine is not adjuvanted, and the qualitative effects of the adjuvant on the immune response may be important in relation to the effect of immunosuppressive drugs on the antibody response. The paper by Salles 19 used seasonal vaccine that does not contain an adjuvant, whilst the work of Labriola 14 and Crespo 15 used Pandemrix. Although in both cases, transplant patients responded less well than dialysis patients when vaccinated, certain formulations may work better in transplant patients than others and could be investigated in the near future.…”

Section: Discussionmentioning

confidence: 99%

Influence of renal replacement therapy on immune response after one and two doses of the A(H1N1) pdm09 vaccine

Quintana

Serra

Molina-Llauradó

et al. 2012

Influenza Resp Viruses

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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.

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“…15 In RTRs, the immune response can be decreased in all patients, 16 or only in patients receiving cyclosporine 17 or mycophenolate mofetil therapy. 18,19 However, the immune response to influenza vaccination has been described as adequate, 20,21 whereas the sero-response to hepatitis B or pneumococcal vaccination after transplantation and dialysis appears to be poor. [21][22][23] The time interval between transplantation and trivalent influenza vaccination has been shown to affect serologic response.…”

mentioning

confidence: 99%

Efficacy and safety of the H1N1 monovalent vaccine in renal-transplant recipients and dialysis patients

Beaudreuil¹,

Krivine²,

Hebibi³

et al. 2011

Human Vaccines

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Influenza virus vaccination in kidney transplant recipients: serum antibody response to different immunosuppressive drugs

Abstract: Renal transplant patients vaccinated against influenza responded with antibody production for influenza A virus strains, but not for influenza B. Use of MMF and shorter time from transplantation decreased the immune response to the vaccine.

Cited by 73 publications

References 29 publications

Influenza A/H1N1 Vaccine in Patients Treated by Kidney Transplant or Dialysis

Influenza A/H1N1 Vaccine in Patients Treated by Kidney Transplant or Dialysis

Influence of renal replacement therapy on immune response after one and two doses of the A(H1N1) pdm09 vaccine

Efficacy and safety of the H1N1 monovalent vaccine in renal-transplant recipients and dialysis patients

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