Safety and Immunogenicity of Heat-Treated Zoster Vaccine (ZVHT) in Immunocompromised Adults

Mullane, Kathleen M.; Winston, Drew J.; Wertheim, M. S.; Betts, Robert F.; Poretz, Donald M.; Camacho, Luis H.; Pergam, Steven A.; Mullane, Michael Russell; Stek, Jon E.; Sterling, Tina; Zhao, Yanli; Manoff, Susan B.; Annunziato, Paula W.

doi:10.1093/infdis/jit344

Cited by 72 publications

(52 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Interestingly, our study suggested that myeloma patients with lower levels of specific VZV antibodies at ASCT had a greater risk for HZ after ASCT (P = 0.009), with good consistency between the ELISA and the immunofluorescence assays. Thus, myeloma patients with low/absent specific VZV antibody levels may be candidates for prolonged antiviral prophylaxis, a vaccination approach [29][30][31] -and/or evaluation of Ig substitution (for which the current literature provides poor evidence). However, such recommendations need to be tested in adequately powered randomized prospective studies.…”

Section: Discussionmentioning

confidence: 99%

Varicella zoster virus reactivation after autologous SCT is a frequent event and associated with favorable outcome in myeloma patients

Kamber

Zimmerli

Suter‐Riniker

et al. 2015

Bone Marrow Transplant

View full text Add to dashboard Cite

The occurrence of varicella zoster virus (VZV) reactivation is increased after allogeneic transplantation, whereas limited data are available for herpes zoster (HZ) after autologous SCT (ASCT). We determined the incidence and the prognostic significance of HZ and its correlation with VZV serology in 191 consecutive myeloma patients undergoing high-dose melphalan chemotherapy with ASCT. We found that VZV reactivation occurred in 57 (30%) patients, in 8.5% during induction and in 21.5% after ASCT peaking at 8 months after ASCT. Disease burden due to HZ was assessed as high or rather high in 70% of the patients. By immune fluorescence and Serion Elisa VZV IgG assessment, 90.8% of all patients had specific anti-VZV antibodies at ASCT. Lower specific antibody titers at transplantation were observed in patients with HZ after ASCT than in those without reactivation (P = 0.009). Finally, OS was better in myeloma patients with HZ after ASCT compared with patients without HZ (P = 0.007). Our data indicate that VZV reactivation after ASCT is a frequent event carrying a significant disease burden and it is associated with improved survival. Low levels of specific VZV antibodies at ASCT suggest increased vulnerability for VZV reactivation.

show abstract

Section: Discussionmentioning

confidence: 99%

Varicella zoster virus reactivation after autologous SCT is a frequent event and associated with favorable outcome in myeloma patients

Kamber

Zimmerli

Suter‐Riniker

et al. 2015

Bone Marrow Transplant

View full text Add to dashboard Cite

show abstract

“…In a study evaluating safety and immunogenicity of four doses of heat-treated zoster vaccine, the first of which was given at 30 days before SCT, the results indicated that autologous but not allogeneic HSCT recipients had a rise in VZV-specific T-cell response. 29 This vaccine and another inactivated vaccine are in phase III clinical trials in immunocompromised patients and might be used for donor/recipient vaccination studies. However, the strategy to vaccinate patients after discontinuation of antiviral prophylaxis should also be explored.…”

Section: Varicellamentioning

confidence: 99%

Pretransplant vaccinations in allogeneic stem cell transplantation donors and recipients: an often-missed opportunity for immunoprotection?

Harris

Styczyński

Bodge

et al. 2015

Bone Marrow Transplant

View full text Add to dashboard Cite

“…The accumulation of CD4 ϩ T cells and CD4 ϩ regulatory T cells at the site of VZV antigen challenge in the skin has recently been described (26). VZV-specific CMI assays have also determined the IFN-␥ protein production of immune cells, i.e., the VZV responder cell frequency by enzyme-linked immunospot assays, flow cytometry (7,27), or IFN-␥ ELISA of supernatants of ex vivo-stimulated lymphocytes (28). The qRT-PCR assay allows highly sensitive testing of the mRNA expression of selected genes of importance in humans (29) and animals (30).…”

Section: Discussionmentioning

confidence: 99%

“…Triple vaccination of bone marrow transplant patients with a heat-inactivated varicella vaccine administered s.c. decreased the severity of herpes zoster (6) and four s.c. doses of a heat-inactivated zoster vaccine proved safe and immunogenic in patients with tumor malignancy, HIV-infected individuals, or hematopoietic stem cell transplant recipients (7). When healthy elderly subjects were immunized s.c. with a single dose of either live or heat-inactivated varicella vaccine, there were no differences in antibody responses or IFN-␥ production by peripheral blood mononuclear cells (8).…”

mentioning

confidence: 99%

High-Level Cellular and Humoral Immune Responses in Guinea Pigs Immunized Intradermally with a Heat-Inactivated Varicella-Zoster Virus Vaccine

Sarkadi

Jankovics

Fodor

et al. 2015

Clin. Vaccine Immunol.

View full text Add to dashboard Cite

V aricella-zoster virus (VZV) causes varicella by primary infection and herpes zoster by reactivation of the latent virus in the sensory ganglia of infected individuals. After primary infection, the immune response comprises VZV-specific antibody and T cell-mediated immunity (CMI), which are important for recovery from varicella. T cell responses are necessary to control latent VZV in the sensory ganglia. A lack or a declining level of CMI to VZV has been associated with a higher risk of development of herpes zoster (1).A varicella vaccine consisting of live, attenuated strain OKA (vOKA) has been developed in Japan and licensed for mass vaccination in Japan, South Korea, the United States, and several European countries or recommended for only selected groups of the population in other countries (2, 3). To prevent herpes zoster, a zoster vaccine containing 14 times as many PFU of vOKA than the varicella vaccine was developed and licensed for the vaccination of immunocompetent subjects older than 60 years in the United States in 2006 (4). Varicella and zoster vaccines are administered by the subcutaneous (s.c.) route. However, vaccination of immunocompromised individuals with live VZV vaccines can be problematic and different strategies for safe immunization need to be explored (5).Several clinical studies have indicated that the use of a heatinactivated VZV vaccine is an alternative mode of immunization of immunocompromised individuals. Triple vaccination of bone marrow transplant patients with a heat-inactivated varicella vaccine administered s.c. decreased the severity of herpes zoster (6) and four s.c. doses of a heat-inactivated zoster vaccine proved safe and immunogenic in patients with tumor malignancy, HIV-infected individuals, or hematopoietic stem cell transplant recipients (7). When healthy elderly subjects were immunized s.c. with a single dose of either live or heat-inactivated varicella vaccine, there were no differences in antibody responses or IFN-␥ production by peripheral blood mononuclear cells (8). These data indicated that a heat-inactivated VZV vaccine might be useful in preventing herpes zoster. However, protection against herpes zoster following immunization with either a live or heat-inactivated vaccine is not optimal and a more potent antigenic stimulus is needed to improve the efficacy of the vaccine in high-risk patients (9).The skin is a highly immunogenic organ (10). Noninvasive, needle-free liquid jet injection of liquid or powder into the skin has been used in clinical trials for immunization against viral infections (11-13). The barrier structure and thickness of the stratum corneum, the outermost layer of the skin, are similar in guinea pigs and humans (18.6 and 18.2 m, respectively) (14), and thus, the i.d. route of immunization and the effectiveness of a potential i.d. delivery device for humans can be tested in guinea pigs. Moreover, the parental OKA strain is attenuated in human

show abstract

Safety and Immunogenicity of Heat-Treated Zoster Vaccine (ZVHT) in Immunocompromised Adults

Cited by 72 publications

References 31 publications

Varicella zoster virus reactivation after autologous SCT is a frequent event and associated with favorable outcome in myeloma patients

Varicella zoster virus reactivation after autologous SCT is a frequent event and associated with favorable outcome in myeloma patients

Pretransplant vaccinations in allogeneic stem cell transplantation donors and recipients: an often-missed opportunity for immunoprotection?

High-Level Cellular and Humoral Immune Responses in Guinea Pigs Immunized Intradermally with a Heat-Inactivated Varicella-Zoster Virus Vaccine

Contact Info

Product

Resources

About