Immunogenicity of pneumococcal vaccination in renal transplant recipients.
Published: 2004
Language: eng
Number of pages: 104
Description: Background. Renal transplant recipients are at increased risk for developing invasive pneumococcal disease but may have a poor response to pneumococcal polysaccharide vaccine (PPV23). The pneumococcal conjugate vaccine (PCV7), which induces a T-cell dependent response, may be more immunogenic in these patients.Methods. This study is a randomized controlled double-blind trial in 60 adult renal transplant recipients at two transplant centers. Patients between 3 months and 3 years post-transplant were given a single dose of PPV23 or PCV7. Immunogenicity was assessed at 8 weeks post-vaccination by serotype-specific antibody and opsonophagocytic assay (OPA).Results. Baseline demographics, renal function, time from transplant and immunosuppression were comparable in the two vaccinated groups. There were no serious acute adverse reactions to either vaccine. The vaccine response rate (defined as a 32-fold rise in antibody titer and an absolute titer of 31 mug/mL) was improved in the conjugate vaccine group for serotypes 23F (p = 0.046), and 6B (p = 0.067) but was not significantly different for the remaining 5 serotypes. Response to at least one serotype occurred in 73.3% vs. 53.3% respectively (p = 0.11). Mean fold increases in antibody titer were for higher with conjugate vaccine for serotypes 23F (p = 0.046) and 9V (p = 0.09). However, response rate and mean fold increase in OPA titer were not significantly different between the two groups for any of the seven serotypes.Conclusion. There was a trend towards enhanced immunogenicity for conjugate vaccine by ELISA. However, functional antibody responses were not different between the two groups.
Notes: Adviser:  Allison J. McGeer.

Thesis (M.Sc.)--University of Toronto, 2004.

Electronic version licensed for access by U. of T. users.

Source: Masters Abstracts International, Volume: 43-03, page: 0818.

MICR copy on microfiche (2 microfiches).