Department of Public Health, Osaka City University Faculty of Medicine, Osaka, Japan.
Influenza Other Respir Viruses. 2013 May;7(3):456-65. doi: 10.1111/j.1750-2659.2012.00424.x. Epub 2012 Aug 16.
Patients with underlying disease represent a high-risk group for influenza-associated complications and hospitalization. However, few studies investigated the immunogenicity of influenza vaccine in patients with liver disease.
To examine immunogenicity of influenza A(H1N1)pdm09 vaccine in patients with liver disease and to explore the associated factors on lowered immune response.
PATIENTS/METHODS: A single subcutaneous dose of monovalent inactivated unadjuvanted split-virus influenza A(H1N1)pdm09 vaccination was performed in 80 patients with chronic hepatitis C virus infection at Osaka City University Hospital in Japan. To measure the hemagglutination inhibition antibody titer, serum samples were collected before and 3 weeks after vaccination.
No serious adverse events were observed. After vaccination, antibody titers ≥1:40 were observed in 56 patients (71%). The corresponding seroconversion proportion was 72%, and the mean fold rise was 10·3. Immune responses were robust regardless of severity of liver disease or existence of probable cirrhosis. However, patients with older age, lower body mass index, or receiving Stronger Neo-Minophagen C tended to show lower antibody responses to A(H1N1)pdm09 vaccine. In addition, reduced immune responses were observed in patients who had received the 2009/10 seasonal vaccination prior to A(H1N1)pdm09 vaccination.
Single dose of A(H1N1)pdm09 vaccine achieved a sufficient level of immunity among patients with chronic hepatitis C. Antibody response may be affected by age, body mass index, Stronger Neo-Minophagen C administration, and recent seasonal influenza vaccination.
患有基础疾病的患者是流感相关并发症和住院的高危人群。然而，很少有研究调查肝病患者流感疫苗的免疫原性。
研究甲型 H1N1 流感疫苗在肝病患者中的免疫原性，并探讨降低免疫应答的相关因素。
患者/方法：在日本大阪市立大学医院，对 80 例慢性丙型肝炎病毒感染患者进行了单剂皮下接种单价无佐剂裂解病毒甲型 H1N1 流感疫苗。为了测量血凝抑制抗体滴度，在接种前和接种后 3 周采集血清样本。
未观察到严重不良事件。接种后，56 例（71%）患者抗体滴度≥1:40。相应的血清转化率为 72%，平均抗体效价升高 10.3 倍。无论肝病严重程度或是否存在可能的肝硬化，免疫反应均较强。然而，年龄较大、体重指数较低或接受更强力新诺明 C 治疗的患者对 A(H1N1)pdm09 疫苗的抗体反应较低。此外，在接受 A(H1N1)pdm09 疫苗接种之前接受了 2009/10 季节性流感疫苗接种的患者中，观察到免疫反应降低。
单剂 A(H1N1)pdm09 疫苗可使慢性丙型肝炎患者获得足够的免疫力。抗体反应可能受年龄、体重指数、更强力新诺明 C 给药和近期季节性流感疫苗接种的影响。
