title: Influenza A/H1N1 vaccine in patients treated by kidney transplant or dialysis: a cohort study.
abstract: OBJECTIVE
  In 2009, the pandemic influenza A/H1N1 accounted for worldwide recommendations about vaccination. There are few data concerning the immunogenicity or the security of the adjuvanted-A/H1N1 vaccine in transplanted and hemodialyzed patients.
  
  
  METHODS
  Sera from 21 controls, 53 hemodialyzed (HD) patients, and 111 renal transplant recipients (RT) were sampled before (T0) and 1 month after (T1) a single dose of Pandemrix® vaccine (GSK Biologicals, AS03-adjuvanted). We measured the neutralizing antibodies against A/H1N1/2009, the geometric mean (GM) titers, the GM titer ratios (T1/T0) with 95% confidence intervals, and the seroconversion rate (responders: ≥4-fold increase in titer). The HLA and MICA immunization was determined by Luminex technology.
  
  
  RESULTS
  The GM titer ratio was 38 (19 to 78), 9 (5 to 16), and 5 (3 to 6) for controls, HD patients, and RT patients, respectively (P < 0.001). The proportion of responders was 90%, 57%, and 44%, respectively (P < 0.001). In RT patients, the prevalence of histocompatibility leukocyte antigen (HLA) class I, histocompatibility leukocyte antigen class II, and MHC class I-related chain A immunization, was, respectively, 15%, 14%, and 14% before and 14%, 14%, and 11% after vaccination (P = 1, 1, and 0.39).
  
  
  CONCLUSIONS
  The influenza A/H1N1-adjuvanted vaccine is of limited efficacy but is safe in renal disease populations. The humoral response is lower in transplanted versus hemodialyzed patients. Further studies are needed to improve the efficacy of vaccination in those populations.
authors.affiliation: Renal Transplantation Clinic, Hospital Erasme, Brussels, Belgium. broedersnilufer@gmail.com
authors.forename: Nilufer E
authors.initials: NE
authors.lastname: Broeders
authors.forename: Anneleen
authors.initials: A
authors.lastname: Hombrouck
authors.forename: Anne
authors.initials: A
authors.lastname: Lemy
authors.forename: Karl Martin
authors.initials: KM
authors.lastname: Wissing
authors.forename: Judith
authors.initials: J
authors.lastname: Racapé
authors.forename: Karine
authors.initials: K
authors.lastname: Gastaldello
authors.forename: Annick
authors.initials: A
authors.lastname: Massart
authors.forename: Steven
authors.initials: S
authors.lastname: Van Gucht
authors.forename: Laura
authors.initials: L
authors.lastname: Weichselbaum
authors.forename: Aurelie
authors.initials: A
authors.lastname: De Mul
authors.forename: Bernard
authors.initials: B
authors.lastname: Brochier
authors.forename: Isabelle
authors.initials: I
authors.lastname: Thomas
authors.forename: Daniel
authors.initials: D
authors.lastname: Abramowicz
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D057134:Antibodies, Neutralizing / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D001530:Belgium; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015331:Cohort Studies; D004338:Drug Combinations; D005260:Female; D015395:Histocompatibility Antigens Class I / Q000276:immunology; D000949:Histocompatibility Antigens Class II / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000009:adverse effects; D007251:Influenza, Human / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D007676:Kidney Failure, Chronic / Q000276:immunology / Q000601:surgery / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011136:Polysorbates / Q000008:administration & dosage; D012044:Regression Analysis; D006435:Renal Dialysis; D013185:Squalene / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome; D024502:alpha-Tocopherol / Q000008:administration & dosage
chemical_list: D057134:Antibodies, Neutralizing; D000914:Antibodies, Viral; D004338:Drug Combinations; D015395:Histocompatibility Antigens Class I; D000949:Histocompatibility Antigens Class II; D007166:Immunosuppressive Agents; D007252:Influenza Vaccines; C099187:MHC class I-related chain A; D011136:Polysorbates; C556153:pandemrix; D013185:Squalene; C550253:AS03 adjuvant; D024502:alpha-Tocopherol