Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
Acta Paediatr. 2018 Dec;107(12):2185-2192. doi: 10.1111/apa.14375. Epub 2018 May 25.
Renal transplant patients are particularly susceptible to highly contagious diseases due to their reduced immunity. We studied transplant recipients to gauge their varicella zoster virus (VZV) serology status over time and the outcome of any VZV infections.
This retrospective study comprised 85 children who underwent renal transplants in Gothenburg, Sweden, from 1986 to 2014, at a mean age of eight (1-18) years. The children's medical records were reviewed and 47 had the VZV infection pre-transplant and 38 had been vaccinated pre-transplant. Clinical outcomes were available for 85 children and serology results for 72.
At transplantation, the VZV seropositivity rate was 50% in the vaccination group and 94% in the infection group and the antibody titres were significantly lower in the vaccination group (p = 0.031). During the median follow-up period of five years post-transplant, 28% of the vaccinated children and 97% of the infection group remained seropositive and the varicella infection affected eight children: one in the infection group and seven in the vaccination group. The herpes zoster was observed in two children in the infection group.
This study demonstrated that VZV vaccination protected from symptomatic infections to a lesser extent than natural infection, but provided effective protection from life-threatening disease.
由于免疫功能降低，肾移植患者特别容易感染具有高度传染性的疾病。我们研究了移植受者，以评估他们随时间推移的水痘带状疱疹病毒（VZV）血清学状态以及任何 VZV 感染的结果。
这项回顾性研究包括了 1986 年至 2014 年在瑞典哥德堡接受肾移植的 85 名儿童，平均年龄为 8 岁（1-18 岁）。回顾了这些儿童的病历，其中 47 名儿童在移植前感染过 VZV，38 名儿童在移植前接种过疫苗。对 85 名儿童的临床结局进行了评估，对 72 名儿童的血清学结果进行了评估。
在移植时，接种疫苗组的 VZV 血清阳性率为 50%，感染组为 94%，且接种疫苗组的抗体滴度显著较低（p = 0.031）。在移植后 5 年的中位随访期间，接种疫苗组的 28%儿童和感染组的 97%儿童仍保持血清阳性，8 名儿童发生水痘感染：感染组 1 名，接种疫苗组 7 名。感染组有两名儿童出现带状疱疹。
本研究表明，VZV 疫苗接种对有症状感染的保护作用不如自然感染，但对危及生命的疾病提供了有效保护。
