HUMORAL RESPONSE TO INFLUENZA VACCINATION IN PATIENTS WITH RENAL FAILURE

Brydak L¹, Roszkowska-Blaim M², Machała M¹, Marusak M²

¹ National Influenza Center WHO, Dept. of Virology, National Institute of Hygiene, Warsaw, Poland

² Dept. of Pediatrics and Nephrology, University Medical School, Warsaw, Poland

Objective: The aim of this study was to assess humoral response to influenza vaccination in the patients with renal failure.

Methods: The study group consisted of 22 patients with renal failure aged 1 to 22 years (mean 14.84 ± 5.41). Among them 5 patients were on hemodialysis, 11 were on automated peritoneal dialysis and 6 on conservative treatment. The control group consisted of 33 healthy subject aged 9 to 22 (mean 15.8 ± 3.55). In the epidemic season 2000/2001 all of them were vaccinated against influenza with one 0.5ml dose of submit vaccine (´Influvac`, Solvay Pharma). Antibody response to hemagglutinin and neuraminidase influenza glycoproteins was assessed before vaccination and 1 month after vaccination by hemagglutinin inhibition test and neuraminidase inhibition test.

Results: Before vaccination antihemagglutinin (HI) antibody titers ranged from 1.8 to 9.2 in patients with renal failure and 1.2 to 28.8 in the control group. In the patients with renal failure mean fold increases (MFIs) of HI antibody levels after vaccination amounted to 31.4 for hemagglutinin H1, 13.9 for hemagglutinin H3 and 17.9 for HB. In the control group MFIs amounted to 69.5, 9.9 and 12.9 respectively. Before vaccination protection rate, i.e. the number of subjects with HI antibody titers ³ 1:40, amounted to 0% for strain A (H1N1), 22.7% for A(H3N2) and 27.2% for B in a group of patients with renal failure. After vaccination protection rate values were 81.8%, 100% and 90.9% respectively. In the control group pre-vaccination protection rates amounted to 0% for A (H1N1), 57.6% for A (H3N2) and 51.5% for strain B. After vaccination these values amounted to 87.9%, 100% and 100% respectively. Response rate, i.e. the number of subjects with at least a 4-fold increase of HI antibody titers after vaccination, ranged from 77.3% to 95.5% in patients with renal failure and from 87.8% to 90.9% in the control group. In the case of antineuraminidase (NI) antibodies pre-vaccination titers ranged from 1.4 to 6.7 in the patients with renal failure and 1.0 to 7.3 in the control group. After vaccination mean fold increases of NI antibody levels amounted to 19.0 for neuraminidase N1, 11.7 for N2 and 8.9 for NB in the patients with renal failure. In the control group these values were 39.2, 11.2 and 13.7 respectively.

Conclusions: The results of this study clearly showed that humoral response to influenza vaccination in patients with renal failure was comparable to that observed in healthy vaccinated subjects.

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