title: Comparison of the PRNT and an immune fluorescence assay in yellow fever vaccinees receiving immunosuppressive medication.
abstract: BACKGROUND
  The 17D-yellow fever (YF) vaccination is considered contraindicated in immune-compromised patients; however, accidental vaccination occurs. In this population, measuring the immune response is useful in clinical practice.
  
  
  METHODS
  In this study we compare two antibody tests (the Immune Fluorescence Assay and the Plaque Reduction Neutralization Test) in a group of Dutch immune-compromised travellers with a median of 33 days (IQR [28-49]) after primary YF vaccination.
  
  
  RESULTS
  We collected samples of 15 immune-compromised vaccinees vaccinated with the 17D yellow fever vaccine between 2004 and 2012. All samples measured in the plaque reduction neutralization test yielded positive results (>80% virus neutralization with a 1:10 serum dilution). Immune Fluorescence Assay sensitivity was 28% (95% CI [0.12-0.49]). No adverse events were reported.
  
  
  CONCLUSIONS
  All immune-compromised patients mounted an adequate response with protective levels of virus neutralizing antibodies to the 17-D YF vaccine. No adverse effects were reported. Compared to the plaque reduction neutralization test, the sensitivity of the Immune Fluorescence Assay test was low. Further research is needed to ascertain that 17D vaccination in immune-compromised patients is safe.
authors: Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: a.goorhuis@amc.uva.nl.
authors: Rosanne W
authors: RW
authors: Wieten
authors: Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands.
authors: Emile F F
authors: EF
authors: Jonker
authors: Department for Immune Mechanisms (IMM), Centre for Immunology od Infectious Diseases and Vaccines (IIV), National Institute for Public Health and the Environment (RIVM), Utrecht, The Netherlands.
authors: Daan K J
authors: DK
authors: Pieren
authors: Department of Virology, Academic Medical Center, Amsterdam, The Netherlands.
authors: Caspar J
authors: CJ
authors: Hodiamont
authors: Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: Pieter P A M
authors: PP
authors: van Thiel
authors: Department of Viroscience, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Eric C M
authors: EC
authors: van Gorp
authors: Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands.
authors: Adriëtte W
authors: AW
authors: de Visser
authors: Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: Martin P
authors: MP
authors: Grobusch
authors: Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands.
authors: Leo G
authors: LG
authors: Visser
authors: Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: Abraham
authors: A
authors: Goorhuis
mesh_terms: D000328:Adult; D000368:Aged; D057134:Antibodies, Neutralizing / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009500:Neutralization Tests; D015004:Yellow Fever / Q000517:prevention & control; D022341:Yellow Fever Vaccine / Q000276:immunology / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D057134:Antibodies, Neutralizing; D000914:Antibodies, Viral; D007166:Immunosuppressive Agents; D022341:Yellow Fever Vaccine
keywords: Immune-compromised; Indirect Fluorescence Assay (IFA); Plaque Reduction Neutralization Test (PRNT); Vaccination; Yellow fever