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Influenza virus vaccination in kidney transplant patients: serum antibody response to different immunosuppressive drugs

Abstract number: P1586

Salles M.J.C., Sens Y.A.S., Machado C.M., Boas L.V.

Objectives: Influenza vaccine response in kidney transplanted patients has shown conflicting results, which can be associated with different immunosuppressive regimens. We prospectively assessed the humoral immunity to the trivalent inactivated influenza vaccine in kidney transplant adult patients.

Methods: 75 renal transplanted patients with at least six months of transplantation received one dose of inactivated influenza vaccine 2004–2005. Anti-hemagglutinin antibody response against each strain was measured by hemagglutination inhibition test before and monthly up to 6 months after. The geometric mean titer (GMT) of each strain was calculated using the log-transformed values from all subjects; the GMT was taken as the antilog of the mean of the transformed value. Logistic regression model was used to assess the impact of different immunosuppressive drugs on the vaccine response rates.

Results: One month after vaccination, 57.4% of patients acquired protective titers of antibodies to at least one vaccine strain. The GMT of H1N1 and H3N2 strains increased from 2.75 and 2.44 to 13.54 (P = 0.001) and 7.30 (P < 0.001) respectively. Pre and post-vaccination protection rates for H1N1 and H3N2 increased from 9.3% to 45.3% (P < 0.001) and 9.3% to 33.3% (P < 0.001). The H1N1 and H3N2 seroconversion rates after vaccination were 36% and 25.3%, respectively. There was no antibody response to influenza B virus. Compared to the use of azathioprine (AZA), Mycophenolate Mofetil (MMF) reduced the H1N1 [P = 0.011, OR 0.26 (IC95% 0.097–0.734)] and H3N2 [P = 0.033, OR 0.30 (IC95% 0.10–0.91)] protection rates and the seroconversion rates for the H3N2 strain [P = 0.036, OR 0.26 (IC95% 0.07–0.91)].

Conclusions: Renal transplanted patients submitted to an anti-influenza vaccination responded with antibody production against strains H1N1 and H3N2 of influenza A virus but not to influenza B virus. Use of MMF decreased the humoral immune response to the anti-influenza vaccine.

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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