Immunisation against varicella in end stage and pre-end stage renal failure. Trans-Pennine Paediatric Nephrology Study Group.
OBJECTIVE
To investigate the seroconversion rate and duration of persistence of protective antibody titres after varicella immunisation in children with renal failure.


METHODS
32 children (25 end stage and 7 pre-end stage renal failure) were immunised using 2 x 2,000 plaque forming unit doses of varicella vaccine 3 months apart. Varicella antibody titres were measured by enzyme linked immunosorbent assay.


RESULTS
All children initially seroconverted after immunisation. At a mean follow up of 20.3 months, 23 of 28 had protective antibody titres, 4 children having died of unrelated causes. Two children required a third booster dose. 11 children underwent renal transplantation; 10 had protective titres at the time of transplantation and, at a mean of 23.4 months after immunisation, 6 currently have protective titres. Minor side effects occurred after 11 vaccine doses in 9 children. No child developed varicella, despite 10 clear episodes of exposure to the wild-type virus.


CONCLUSIONS
Varicella immunisation in children with end stage and pre-end stage renal failure results in a high rate of seroconversion and persistence of protective antibody titres. More widespread use of the vaccine before renal transplantation is recommended.
Webb
N J
NJ
Department of Paediatric Nephrology, Royal Manchester Children's Hospital, Pendlebury, Manchester M27 4HA, UK. nwebb@lycosmail.com
Fitzpatrick
M M
MM
Hughes
D A
DA
Brocklebank
T J
TJ
Judd
B A
BA
Lewis
M A
MA
Postlethwaite
R J
RJ
Smith
P A
PA
Corbitt
G
G
D000914:Antibodies, Viral / Q000096:biosynthesis* / Q000097:blood; D002644:Chickenpox / Q000517:prevention & control; D019433:Chickenpox Vaccine / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D014645:Herpesvirus 3, Human / Q000276:immunology*; D006801:Humans; D007114:Immunization; D007676:Kidney Failure, Chronic / Q000276:immunology* / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D011446:Prospective Studies
D000914:Antibodies, Viral; D019433:Chickenpox Vaccine