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肾移植受者和血液透析患者对甲型 H1N1 流感疫苗(Pandemrix®)和 2009/2010 季节性流感疫苗的血清学反应。

Serological response to influenza A H1N1 vaccine (Pandemrix®) and seasonal influenza vaccine 2009/2010 in renal transplant recipients and in hemodialysis patients.

机构信息

KfH Nierenzentrum, Jena, Germany.

出版信息

Med Microbiol Immunol. 2012 Aug;201(3):297-302. doi: 10.1007/s00430-012-0231-8. Epub 2012 Feb 17.

DOI:10.1007/s00430-012-0231-8
PMID:22350187
Abstract

In the present study, antibody response to seasonal influenza vaccination and to the adjuvanted one-shot influenza A H1N1 vaccine (Pandemrix(®)) was investigated in 57 hemodialysis (HD) patients and 48 renal transplant (RT) recipients. Specific antibodies were measured by hemagglutination inhibition (HI) test using a pandemic H1N1 strain and a seasonal H3N2 virus. HI titers of ≥1:40 were considered as protective. Hemodialysis patients showed seroprotection against pandemic H1N1 in 35.1%, against seasonal influenza in 36.8% and against both in 14.0%. In comparison, renal transplant recipients developed protective antibody titers against the pandemic H1N1 virus in 47.9%, against the seasonal H3N2 strain in 31.3% and against both in 18.8%. HD patients and renal transplant recipients younger than 60 years developed protective antibody response to the pandemic influenza H1N1 vaccine in 50.0% of the HD patients and 55.2% of the RT recipients and against seasonal influenza in 45.0/20.7% (HD/RT) of the cases. Patients aged ≥60 years showed seroprotection against pandemic influenza in 27.0/36.8% (HD/RT) and against seasonal influenza in 32.4/47.4% (HD/RT). Side effects were reported in only four patients. In hemodialysis patients and renal transplant recipients, vaccination against pandemic H1N1 and seasonal influenza is well tolerated. However, more than a half of these patients did not develop seroprotective antibody levels. Thus, new vaccines and altered vaccination regimes are likely necessary to achieve relevant antibody levels in these patient groups.

摘要

在本研究中,我们调查了 57 名血液透析(HD)患者和 48 名肾移植(RT)受者对季节性流感疫苗和含佐剂的单剂流感 A H1N1 疫苗(Pandemrix(®))的抗体反应。使用大流行 H1N1 株和季节性 H3N2 病毒通过血凝抑制(HI)试验测量特异性抗体。HI 滴度≥1:40 被认为具有保护作用。血液透析患者对大流行 H1N1 的血清保护率为 35.1%,对季节性流感的血清保护率为 36.8%,两者均为 14.0%。相比之下,肾移植受者对大流行 H1N1 病毒产生保护性抗体滴度的比例为 47.9%,对季节性 H3N2 株的为 31.3%,两者均为 18.8%。年龄<60 岁的血液透析患者和肾移植受者对大流行流感 H1N1 疫苗产生保护性抗体反应的比例分别为 50.0%和 55.2%,对季节性流感的比例分别为 45.0/20.7%(HD/RT)。年龄≥60 岁的患者对大流行流感的血清保护率为 27.0/36.8%(HD/RT),对季节性流感的血清保护率为 32.4/47.4%(HD/RT)。仅报告了四名患者出现副作用。在血液透析患者和肾移植受者中,接种大流行流感 H1N1 和季节性流感疫苗具有良好的耐受性。然而,这些患者中超过一半没有产生保护性抗体水平。因此,可能需要新的疫苗和改变的疫苗接种方案,以使这些患者群体产生相关的抗体水平。

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