Renal Transplantation Clinic, Hospital Erasme, Brussels, Belgium.
Clin J Am Soc Nephrol. 2011 Nov;6(11):2573-8. doi: 10.2215/CJN.04670511. Epub 2011 Sep 15.
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: ≥4-fold increase in titer). The HLA and MICA immunization was determined by Luminex technology.
The 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 < 0.001). The proportion of responders was 90%, 57%, and 44%, respectively (P < 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 = 1, 1, and 0.39).
The 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.
2009 年，大流行性流感 A/H1N1 在全球范围内引发了接种疫苗的建议。关于佐剂 A/H1N1 疫苗在移植和血液透析患者中的免疫原性或安全性的数据很少。
设计、设置、参与者和测量：在单次接种潘立酮®疫苗（GSK 生物制品公司，AS03 佐剂）前后，从 21 名对照者、53 名血液透析（HD）患者和 111 名肾移植受者（RT）中抽取血清样本（T0）和 1 个月后（T1）。我们测量了针对 A/H1N1/2009 的中和抗体，几何平均（GM）滴度，GM 滴度比（T1/T0）和 95%置信区间，以及血清转化率（应答者：滴度增加 4 倍以上）。HLA 和 MICA 免疫接种通过 Luminex 技术确定。
对照组、HD 患者和 RT 患者的 GM 滴度比分别为 38（19 至 78）、9（5 至 16）和 5（3 至 6）（P <0.001）。应答者的比例分别为 90%、57%和 44%（P <0.001）。在 RT 患者中，组织相容性白细胞抗原（HLA）I 类、组织相容性白细胞抗原 II 类和 MHC Ⅰ类相关链 A 免疫接种的患病率，分别为 15%、14%和 14%，接种前后分别为 14%、14%和 11%（P=1、1 和 0.39）。
流感 A/H1N1 佐剂疫苗疗效有限，但在肾病患者中是安全的。与血液透析患者相比，移植患者的体液反应较低。需要进一步研究以提高这些人群疫苗的疗效。
