title: Humoral and cellular response after varicella vaccination in VZV IgG seronegative kidney transplant candidates.
abstract: In immunocompromised patients, primary infection with VZV may have a disastrous clinical course. Vaccination of VZV-seronegative patients on the waiting list for renal transplantation may prevent severe disease. However, the immunologic response of end-stage renal disease patients to peptide vaccines is far from optimal. Our question was whether end-stage renal disease patients with undetectable VZV-IgG levels were able to mount an adequate humoral and cellular response to a live attenuated varicella vaccine.
  
  
  
  Kidney transplant candidates with undetectable VZV levels were vaccinated twice with a live attenuated varicella vaccine at an interval of 6weeks. VZV IgG levels were analysed till 2years after vaccination. The VZV-specific T-cell reactivity was determined prior to vaccination and after transplantation.
  
  
  
  Seventy-seven percent (40/52) of the vaccinees reached positive VZV-IgG levels after vaccination (responders). Eighty-two percent (9/11) showed an increase in VZV-specific CD4+memory T-cells (both central and effector memory cells). The percentage VZV-specific CD8+memory T-cells did not increase. None of the non-responders suffered from primary VZV after transplantation. No severe vaccine-related adverse events were reported, only spontaneously resolving local skin irritation.
  
  
  
  The live attenuated varicella vaccine evokes positive VZV IgG-levels and VZV-specific memory T-cells in VZV-seronegative potential kidney transplant candidates.
authors.affiliation: Internal Medicine - Nephrology & Transplantation, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: m.kho@erasmusmc.nl.
authors.forename: Marcia M L
authors.initials: MM
authors.lastname: Kho
authors.affiliation: Internal Medicine - Nephrology & Transplantation, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Joke M
authors.initials: JM
authors.lastname: Zuijderwijk
authors.affiliation: Viroscience, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Annemiek A
authors.initials: AA
authors.lastname: van der Eijk
authors.affiliation: Internal Medicine - Nephrology & Transplantation, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Ronella
authors.initials: R
authors.lastname: de Kuiper
authors.affiliation: Internal Medicine - Nephrology & Transplantation, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Marieken J
authors.initials: MJ
authors.lastname: Boer-Verschragen
authors.affiliation: Internal Medicine - Nephrology & Transplantation, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Willem
authors.initials: W
authors.lastname: Weimar
authors.affiliation: Internal Medicine - Nephrology & Transplantation, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: van Besouw
mesh_terms: D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D019433:Chickenpox Vaccine / Q000008:administration & dosage* / Q000276:immunology*; D005260:Female; D014645:Herpesvirus 3, Human / Q000276:immunology*; D006801:Humans; D007111:Immunity, Cellular; D056724:Immunity, Humoral; D007074:Immunoglobulin G / Q000097:blood; D007156:Immunologic Memory; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013601:T-Lymphocytes / Q000276:immunology; D066027:Transplant Recipients; D014613:Vaccines, Attenuated / Q000008:administration & dosage / Q000276:immunology; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D019433:Chickenpox Vaccine; D007074:Immunoglobulin G; D014613:Vaccines, Attenuated
keywords: End-stage renal disease; Kidney transplantation; Memory T-cells; VZV-IgG; Varicella vaccine; Varicella zoster virus