Seroconversion of 2009 pandemic influenza A (H1N1) vaccination in kidney transplant patients and the influence of different risk factors.

摘要: Background Influenza may present a high morbidity and mortality in solid organ transplanted patients (SOTP). Annual influenza virus vaccine is recommended for SOTP. However, low levels of seroconversion SOTP have been reported. The aim this study was to evaluate the immunogenicity 2009 pandemic A (H1N1) – A(H1N1)pdm09 kidney transplant analyze which features might affect seroconversion. Methods This conducted from March August 2010 at Renal Transplantation Unit University Sao Paulo, Brazil. total 85 renal attending outpatient unit received one 15-μg intramuscular dose (reassortant A/California/7/2009 [NYMC X-179A]). Blood samples were collected immediately before 21 days after given. Antibody response measured by standard hemagglutination-inhibition (HI) assay. primary endpoint previously seronegative (HI titers <1:40), secondary identification that could population. Results Five (5.9%) presented HI prevaccination ≥1:40 excluded further analysis. Seroconversion negative occurred 27 (34%) 80 patients. Prevaccination geometrical mean 5.8 postvaccination 19.6 (ratio 3.4). Significant rate factors female gender, non-Caucasian ethnicity, post-transplant time vaccination. No impact seen on age, donor type, tacrolimus cyclosporine blood levels, function, or lymphocyte counts. Mycophenolate (MPA) showed lower when compared with azathioprine. Tacrolimus had similar rates. Sirolimus use associated highest seroconversion, although these patient numbers low. Immunosuppresssion containing MPA considerably less effective than drug combinations no MPA. Patients receiving sirolimus more chance seroconversion. geometric means pre/post as follows: (n = 56): 5.8/12.8; (n = 50): 5.9/16.2; (n = 18): 5.4/24.2; azathioprine (n = 19): 6.2/51.6; (n = 6): 8/80. By univariate analysis, being non-White variables 3.3 times male White. In multivariate remaining model hazard ratios. Conclusions In study, monovalent demonstrated rates particularly MPA, but potentially higher sirolimus.