Immunogenicity of trivalent influenza vaccines in patients with chronic kidney disease undergoing hemodialysis: MF59-adjuvanted versus non-adjuvanted vaccines
Immunogenicity of trivalent influenza vaccines in patients with chronic kidney disease undergoing hemodialysis: MF59-adjuvanted versus non-adjuvanted vaccines
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DOI：
10.1080/21645515.2016.1191717
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发表时间：
2016-01-01
影响因子：
4.8
通讯作者：
Kim, Woo Joo
中科院分区：
文献类型：
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作者：
Noh, Ji Yun;Song, Joon Young;Kim, Woo Joo
背景：慢性肾脏疾病（CKD）患者因流感发病和死亡的风险增加。然而，已知流感疫苗的免疫原性在这些患者中减弱。在这项研究中，比较了mf59佐剂和非佐剂三价流感疫苗在血液透析（HD）的CKD患者中的免疫原性。方法：2013-2014年，179例CKD合并HD患者参与研究。将患者随机分为mf59佐剂疫苗组和非佐剂疫苗组，分别接种各自的疫苗。接种前、接种后1个月（mf59佐剂疫苗组88例，非佐剂疫苗组86例）和接种后6个月采集血清。测定血凝抑制抗体水平。结果：接种后1个月，mf59佐剂组3种疫苗的血清转换率均显著高于未佐剂组（A/H1N1 47.7% vs. 17.4%; A/H3N2 42.0% vs. 16.3%; B 31.8% vs. 7.0%, P < 0.01）。接种1个月后，接种mf59佐剂组的A/H1N1、A/H3N2和B型病毒几何平均滴度较接种前增加了2倍，显著高于未接种佐剂组。在老年患者（>= 65岁）中，mf59佐剂组在接种乙型流感毒株后1个月的血清转换率高于未佐剂组（33.3% vs. 7.1%, P = 0.03）。结论：mf59佐剂流感疫苗对慢性肾病合并HD患者的免疫原性优于非佐剂流感疫苗。
Backgrounds: Patients with chronic kidney disease (CKD) are at an increased risk of morbidity and mortality from influenza. However, the immunogenicity of influenza vaccine is known to be attenuated in these patients. In this study, the immunogenicity of MF59-adjuvanted and non-adjuvanted trivalent influenza vaccines was compared in CKD patients undergoing hemodialysis (HD).Methods: During 2013-2014, 179 CKD patients undergoing HD participated in the study. The patients were randomized into either MF59-adjuvanted vaccine group or non-adjuvanted vaccine group and were immunized with the respective vaccine. Sera were collected prior to vaccination and at 1 month (88 patients in MF59-adjuvanted vaccine group and 86 patients in non-adjuvanted vaccine group) and 6 months post vaccination. Levels of hemagglutination inhibition antibodies were measured.Results: The seroconversion rate of all 3 vaccine strains at 1 month post-vaccination was significantly higher in the MF59-adjuvanted group than in the non-adjuvanted group (47.7% vs. 17.4%, A/H1N1; 42.0% vs. 16.3%, A/H3N2; 31.8% vs. 7.0%, B, P < 0.01). One month post-vaccination, the fold increase in geometric mean titer from pre-vaccination for A/H1N1, A/H3N2 and B viruses was significantly greater in the MF59-adjuvanted group than in the non-adjuvanted group. In elderly patients (>= 65 years), the seroconversion rate at 1 month post-vaccination against influenza B strain was higher in the MF59-adjuvanted group than in the non-adjuvanted group (33.3% vs. 7.1%, P = 0.03).Conclusion: The MF59-adjuvanted influenza vaccine showed better immunogenicity than the non-adjuvanted influenza vaccine in CKD patients undergoing HD.