P521 Cytomegalovirus infection and response to influenza vaccination in inflammatory bowel disease patients on anti-TNF therapy

Guidi, L.; Andrisani, G.; Frasca, D.; Cattani, Paola; Marzo, Manuela; Felice, Carla; Pugliese, Daniela; Papa, A.; Rapaccini, Gian Ludovico; Blomberg, Bonnei; Armuzzi, Alessandro

doi:10.1016/s1873-9946(14)60641-3

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“…Next, we investigated by odds ratio (OR) analysis whether there is any evidence for a positive (OR > 1) or negative (OR < 1) association between CMV seropositivity (exposure) and response to influenza vaccination (outcome b). From five studies, a clear definition of responders and non-responders could be extracted [40, 51–54] for different influenza strains and age groups, leading to a total of 13 OR records (Supplementary figure 3). Most studies defined a response to influenza vaccination as a ≥ 4-fold increase in antibody titer after vaccination; one study (Strindhall et al, 2016) used the stricter definition of a ≥ 4-fold increase in antibody titer and a post-titer of ≥ 40 HAU.…”

Section: Resultsmentioning

confidence: 99%

Effect of latent cytomegalovirus infection on the antibody response to influenza vaccination: a systematic review and meta-analysis

Berg

Warmink

Borghans

et al. 2019

Med Microbiol Immunol

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Latent infection with cytomegalovirus (CMV) is thought to accelerate aging of the immune system. With age, influenza vaccine responses are impaired. Although several studies investigated the effect of CMV infection on antibody responses to influenza vaccination, this led to contradicting conclusions. Therefore, we investigated the relation between CMV infection and the antibody response to influenza vaccination by performing a systematic review and meta-analysis. All studies on the antibody response to influenza vaccination in association with CMV infection were included ( n = 17). The following outcome variables were extracted: (a) the geometric mean titer pre-/post-vaccination ratio (GMR) per CMV serostatus group, and in addition (b) the percentage of subjects with a response per CMV serostatus group and (c) the association between influenza- and CMV-specific antibody titers. The influenza-specific GMR revealed no clear evidence for an effect of CMV seropositivity on the influenza vaccine response in young or old individuals. Meta-analysis of the response rate to influenza vaccination showed a non-significant trend towards a negative effect of CMV seropositivity. However, funnel plot analysis suggests that this is a consequence of publication bias. A weak negative association between CMV antibody titers and influenza antibody titers was reported in several studies, but associations could not be analyzed systematically due to the variety of outcome variables. In conclusion, by systematically integrating the available studies, we show that there is no unequivocal evidence that latent CMV infection affects the influenza antibody response to vaccination. Further studies, including the level of CMV antibodies, are required to settle on the potential influence of latent CMV infection on the influenza vaccine response. Electronic supplementary material The online version of this article (10.1007/s00430-019-00602-z) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%