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成人实体器官移植候选人群中针对三种脊灰病毒血清型的抗体血清阳性率和 IPV 疫苗反应。

Seroprevalence of antibodies against the three serotypes of poliovirus and IPV vaccine response in adult solid organ transplant candidates.

机构信息

Laboratório de Pesquisa em Imunização e Vigilância em Saúde (LIVS), Evandro Chagas National Institute of Infectious Diseases (INI - Fiocruz), Rio de Janeiro, Brazil.

Department of Preventive Medicine, Federal University of Rio de Janeiro, Brazil.

出版信息

Vaccine. 2018 Jul 25;36(31):4681-4686. doi: 10.1016/j.vaccine.2018.06.031. Epub 2018 Jun 21.

Abstract

OBJECTIVES

To assess the prevalence of protective antibody titers to polioviruses in adults candidates for solid organ transplant (SOT), and to assess the immunogenic response to inactivated polio vaccine in this population.

METHODS

The study included SOT candidates referred to Immunization Reference Centre of Evandro Chagas National Institute of Infectious Diseases from March 2013 to January 2016. It was conducted in 2 phases. The first one, a cross-sectional seroprevalence study, followed by an uncontrolled analysis of vaccine response among patients without protective antibody titers at baseline. Antibody titers to poliomyelitis were determined by microneutralization assay.

RESULTS

Among 206 SOT candidates included, 156 (76%) had protective antibody titers to all poliovirus serotypes (95% CI: 70-81%). Proven history of oral vaccination in childhood was not associated with higher seroprevalence of protective antibody. In 97% of individuals without protective antibody titers at baseline, there was adequate vaccine response with one dose of inactivated polio vaccine.

CONCLUSIONS

A relevant proportion of adult candidates for SOT does not have protective titers of antibodies to one or more poliovirus serotype. One dose of inactivated vaccine elicited protective antibody titers in 97% of these subjects and should be routinely prescribed prior to SOT.

摘要

目的

评估实体器官移植(SOT)候选者成人中针对脊髓灰质炎病毒的保护性抗体滴度的流行情况,并评估该人群对灭活脊髓灰质炎疫苗的免疫应答。

方法

本研究纳入了 2013 年 3 月至 2016 年 1 月期间向埃万德罗·查加斯国家传染病研究所免疫参考中心转诊的 SOT 候选者。研究分为两个阶段进行。第一阶段为横断面血清流行率研究,随后对基线时无保护性抗体滴度的患者进行疫苗反应的非对照分析。采用微量中和试验测定脊髓灰质炎抗体滴度。

结果

在 206 名 SOT 候选者中,156 名(76%)对所有脊髓灰质炎病毒血清型均具有保护性抗体滴度(95%CI:70-81%)。儿童时期口服疫苗的证实史与保护性抗体的高血清流行率无关。在基线时无保护性抗体滴度的 97%个体中,一剂灭活脊髓灰质炎疫苗可引起足够的疫苗反应。

结论

相当一部分 SOT 候选者成人对一种或多种脊髓灰质炎病毒血清型没有保护性抗体滴度。一剂灭活疫苗可使 97%的此类患者产生保护性抗体滴度,应在 SOT 前常规开具。

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