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Serum bactericidal antibody response to polysaccharide meningococcal vaccination in common variable immunodeficiency and its clinical implications

Abstract number: P1335

Rezaei N., Aghamohammadi A., Siadat S., Moin M., Pourpak Z., Nejati M., Ahmadi H., Kamali S., Norouzian D., Tabaraiee B., Read R.

Objectives: Common variable immunodeficiency (CVID) is a heterogeneous group of disorders, characterised by hypogammaglobulinaemia and recurrent bacterial infections. Some patients with CVID make a successful immune response to polysaccharide vaccine. In this study, we examined the clinical features of those patients with CVID who respond poorly to polysaccharide meningococcal vaccine.

Methods: Twenty-five cases with CVID (18 male and 7 female) and 25 healthy volunteers received meningococcal polysaccharide vaccine A + C. Serum bactericidal antibody (SBA) titres were measured at baseline and after 3 weeks. Response was correlated with clinical and immunological manifestations of CVID.

Results: The serum bactericidal geometric mean titres (GMT) post-vaccination in the CVID patient group was 7.36, which was much lower than the control group (12.13). Twenty-four of 25 controls (96%) had a protective SBA titre of geqslant R: gt-or-equal, slanted8 post vaccination, whereas only 16 of 25 CVID patients (64%) had a protective titre (P-value=0.013). Amongst the cases of CVID who were non-responders, there was a significantly increased rate of bronchiectasis (P =0.008), splenomegaly (P =0.016), and autoimmunity (P =0.034) in comparison with patients who had protective SBA titres. A reversed CD4/CD8 ratio was more common in the non-responder group of patients.

Conclusion: The responder patients may have a good prognosis, while non-responder patients may have undefined immune abnormalities leading to several complications, such as bronchiectasis, opportunistic infections, splenomegaly, and autoimmunity. Therefore, vaccination response may provide a novel functional sub-classification of CVID patients, enabling accurate prognostic evaluation to identify high-risk patients at the time of diagnosis.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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