Yi Yongjin, Park Hayne, Jung Jaehun
Division of Nephrology, Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea.
Department of Preventive Medicine, Armed Forces Medical Command, Seongnam, Korea.
Kidney Res Clin Pract. 2018 Dec;37(4):366-372. doi: 10.23876/j.krcp.18.0044. Epub 2018 Dec 31.
An inactivated Hantaan virus vaccine (iHV) has been broadly used as a preventive strategy for hemorrhagic fever with renal syndrome (HFRS) by the South Korean Army. After the vaccination program was initiated, the overall incidence of HFRS cases was reduced in the military population. While there are about 400 HFRS cases annually, few studies have demonstrated the efficacy of the iHV in field settings. Therefore, this study aimed to evaluate the iHV efficacy on HFRS severity.
From 2009 to 2017, HFRS cases were collected in South Korean Army hospitals along with patients' vaccination history. HFRS patients were classified retrospectively into two groups according to vaccination records: no history of iHV vaccination and valid vaccination. Vaccine efficacy on the severity of acute kidney injury (AKI) stage and dialysis events were investigated.
The effects of the iHV on renal injury severity in between 18 valid vaccinated and 110 non-vaccinated patients were respectively evaluated. In the valid vaccination group, six of the 18 HFRS patients (33.3%) had stage 3 AKI, compared to 60 of the 110 (54.5%) patients in the non-vaccination group. The iHV efficacy against disease progression (VE) was 58.1% (95% confidence interval, 31.3% to 88.0%).
The iHV efficacy against the progression of HFRS failed to demonstrate statistically significant protection. However, different severity profiles were observed between the iHV and non-vaccination groups. Additional studies with larger populations are needed to demonstrate the effectiveness of the iHV in patients with HFRS.
灭活汉坦病毒疫苗（iHV）已被韩国军队广泛用作肾综合征出血热（HFRS）的预防策略。疫苗接种计划启动后，军队人群中HFRS病例的总体发病率有所降低。虽然每年约有400例HFRS病例，但很少有研究证明iHV在实际环境中的疗效。因此，本研究旨在评估iHV对HFRS严重程度的疗效。
2009年至2017年，收集韩国军队医院的HFRS病例及患者的疫苗接种史。根据接种记录，将HFRS患者回顾性分为两组：无iHV疫苗接种史组和有效接种组。研究了疫苗对急性肾损伤（AKI）分期严重程度和透析事件的疗效。
分别评估了18例有效接种和110例未接种患者中iHV对肾损伤严重程度的影响。在有效接种组中，18例HFRS患者中有6例（33.3%）发生3期AKI，而未接种组的110例患者中有60例（54.5%）发生3期AKI。iHV对疾病进展的疗效（VE）为58.1%（95%置信区间，31.3%至88.0%）。
iHV对HFRS进展的疗效未能显示出统计学上的显著保护作用。然而，在iHV组和未接种组之间观察到了不同的严重程度特征。需要进行更多人群的进一步研究来证明iHV在HFRS患者中的有效性。
