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免疫功能低下成年人中经热处理的带状疱疹疫苗(ZVHT)的安全性和免疫原性。

Safety and immunogenicity of heat-treated zoster vaccine (ZVHT) in immunocompromised adults.

机构信息

University of Chicago Medical Center, Illinois.

出版信息

J Infect Dis. 2013 Nov 1;208(9):1375-85. doi: 10.1093/infdis/jit344. Epub 2013 Aug 1.

DOI:10.1093/infdis/jit344
PMID:23908479
Abstract

BACKGROUND

Safety and immunogenicity of heat-treated zoster vaccine (ZVHT) were assessed in immunocompromised adults.

METHODS

In a randomized, double-blind, placebo-controlled, multicenter study, 4 doses ZVHT or placebo were administered approximately 30 days apart to adults with either solid tumor malignancy (STM); hematologic malignancy (HM); human immunodeficiency virus (HIV) with CD4(+) ≤200; autologous hematopoietic stem-cell transplant (HCT) or allogeneic-HCT recipients. Varicella-zoster virus (VZV) T-cell responses by interferon-γ enzyme-linked immunospot (IFN-γ ELISPOT) and VZV antibody concentrations by glycoprotein enzyme-linked immunosorbent assay (gpELISA) were measured at baseline and approximately 28 days after each dose.

RESULTS

No safety signals were found in any group. IFN-γ ELISPOT geometric mean fold rises (GMFR) after dose 4 in STM, HM, HIV, and autologous-HCT patients were 3.00 (P < .0001), 2.23 (P = .004), 1.76 (P = .026), and 9.01 (P = NA), respectively. Similarly, antibody GMFR were 2.35 (P < .0001), 1.28 (P = .003), 1.37 (P = .017), and 0.90 (P = NA), respectively. T-cell and antibody responses were poor after 4 doses of ZVHT in allogeneic-HCT patients.

CONCLUSION

ZVHT was generally safe and immunogenic through 28 days post-dose 4 in adults with STM, HM, and HIV. Autologous-HCT but not allogeneic-HCT patients had a rise in T-cell response; antibody responses were not increased in either HCT population. Study identification. V212-002 Clinical Trials Registration. NCT00535236.

摘要

背景

在免疫功能低下的成年人中评估了经热处理的带状疱疹疫苗(ZVHT)的安全性和免疫原性。

方法

在一项随机、双盲、安慰剂对照、多中心研究中,4 剂 ZVHT 或安慰剂大约相隔 30 天给予患有实体瘤恶性肿瘤(STM);血液恶性肿瘤(HM);CD4(+)≤200 的人类免疫缺陷病毒(HIV);自体造血干细胞移植(HCT)或异基因-HCT 受者。在基线和每次剂量后约 28 天,通过干扰素-γ酶联免疫斑点(IFN-γ ELISPOT)测定水痘带状疱疹病毒(VZV)T 细胞反应,通过糖蛋白酶联免疫吸附试验(gpELISA)测定 VZV 抗体浓度。

结果

在任何组中均未发现安全性信号。STM、HM、HIV 和自体-HCT 患者在第 4 剂后 IFN-γ ELISPOT 几何平均倍数增加(GMFR)分别为 3.00(P <.0001)、2.23(P =.004)、1.76(P =.026)和 9.01(P = NA)。同样,抗体 GMFR 分别为 2.35(P <.0001)、1.28(P =.003)、1.37(P =.017)和 0.90(P = NA)。在所有异体-HCT 患者中,4 剂 ZVHT 后 T 细胞和抗体反应均较差。

结论

在 STM、HM 和 HIV 成人中,ZVHT 在第 4 剂后 28 天内通常是安全且具有免疫原性的。自体-HCT 但不是异体-HCT 患者的 T 细胞反应升高;在任何 HCT 人群中,抗体反应均未增加。研究识别。V212-002 临床试验注册。NCT00535236。

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