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      Immune Response to Haemophilus influenzae Type b Vaccination inRenal Transplant Recipients with Well-Functioning Allografts


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          Background: Haemophilus influenzae infection is a mild and self-limited disease in the healthy population. However, it may show an aggressive course in the immunocompromised state which underlines the importance of vaccination against this agent. On the other hand, posttranplant immunosuppression may impair immune responses and thus the efficacy of the vaccination. Methods: Forty-three renal transplant recipients with well-functioning allografts were immunized with H. influenzae type b vaccine in order to investigate the immune response. The patients received a double or a triple immunosuppressive protocol. Seven healthy members of the dialysis unit served as controls. After obtaining basal serum samples, the patients and the control subjects were immunized with H. influenzae type b conjugate vaccine. After 6 and 12 weeks, serum samples obtained again to determine H. influenzae type b antibody titers. Results: The antibody titers 6 and 12 weeks after vaccination were significantly higher as compared with the basal values, similar to those of the control subjects. These titers did not show statistically significant differences between the double and triple immunosuppressive therapy groups. After 12 weeks of vaccination, the antibody titers did not show a statistically significant difference as compared with those obtained after 6 weeks. Conclusion: H. influenzae type b vaccination is safe and effective in patients with well-functioning renal allografts and should be recommended to renal transplant recipients who may have the risk of invasive disease on the basis of the immunosuppressive state.

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          Most cited references4

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          Routine immunizations in adult renal transplant recipients.

          Vaccination guidelines for transplant recipients include regular boosters of tetanus, diphtheria, and inactivated polio vaccine, but there are few published data on the efficacy of these vaccines in patients receiving immunosuppressive therapy.
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            Efficacy of Haemophilus influenzae type b conjugate vaccine PRP-T.

            Efficacy of the Haemophilus influenzae type b (Hib) conjugate vaccine PRP-T (Pasteur-Merieux) was evaluated in a controlled community intervention study in the Oxford region, UK. PRP-T was offered to infants from May 1, 1991 in three of the region's eight districts and from July 1, 1991, in a fourth district. It was given by separate injection in addition to the standard diphtheria, tetanus, and pertussis vaccine according to an accelerated 2, 3, and 4 month schedule without a booster dose in the second year of life. By October 1, 1992, more than 90% of infants in vaccine districts had received at least one dose of PRP-T. None of the infants given three doses had developed Hib infection, whereas 11 infections occurred in the control population (vaccine efficacy 100%, 95% CI 80-100%). Intention-to-treat analysis also showed a high estimate of efficacy for the vaccine (90%, 50-99%). Follow-up of study children until November 1, 1993, has shown only 1 vaccine failure in an infant, and no invasive infections in those older than 1 year (average age 22 months). PRP-T vaccine had high protective efficacy with an accelerated immunisation schedule. Furthermore, the vaccine appears to remain protective through the second year of life without a booster dose. These findings provide encouragement for use of PRP-T in the Expanded Programme of Immunisation.
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              Immunization of adults.


                Author and article information

                S. Karger AG
                13 January 1999
                : 81
                : 1
                : 55-59
                aDepartment of Nephrology, bDepartments of Microbiology and Infectious Diseases, Istanbul School of Medicine, Millet Caddesi, Çapa, İstanbul, Turkey
                45246 Nephron 1999;81:55–59
                © 1999 S. Karger AG, Basel

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                Page count
                Tables: 2, References: 21, Pages: 5
                Self URI (application/pdf): https://www.karger.com/Article/Pdf/45246
                Self URI (text/html): https://www.karger.com/Article/FullText/45246
                Self URI (journal page): https://www.karger.com/SubjectArea/Nephrology
                Original Paper

                Cardiovascular Medicine,Nephrology
                Haemophilus influenzae vaccination,Transplantation,Immunosuppression


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