Portal de Periódicos da CAPES

SUCCESSFUL VACCINATION AGAINST VARICELLA ZOSTER VIRUS PRIOR TO KIDNEY TRANSPLANTATION

2004; Wolters Kluwer; Volume: 78; Linguagem: Inglês

10.1097/00007890-200407271-01322

1534-6080

Annemarie Geel, Willij C. Zuidema, Teun van Gelder, Gerard van Doornum, Willem Weimar,

Parvovirus B19 Infection Studies

P826 Introduction: Varicella zoster virus (VZV) belongs to the group of Herpetoviridae, which also includes the herpes hominis viruses 1, 2, 6, 7 and 8, cytomegalovirus and Epstein-Barr virus. Just as these viruses, VZV remains present in the body in a latent state after a primary infection (chickenpox). When the cellular/humoral resistance decreases, it may reactivate from the nerve cells and lead to skin eruptions: shingles. If a primary infection occurs during a state of immunosuppression, for example after kidney transplantation, this might have serious consequences. In the last years, we observed 3 young adult kidney transplantation patients dying of the complications from such a primary infection. Vaccination against VZV prior to kidney transplantation might prevent such complications. We wondered, how many patients on the waiting list were not protected against VZV, as can be concluded from a negative serum antibody level. Further, we examined, whether patients with a renal insufficiency would be able to build up a specific immune response upon VZV vaccination. Methods & results: On 1 August 2003, 280 patients were on the kidney transplant waiting list in our region. The VZV antibody level was examined for all patients, and in 9 cases (3,2%) proved to be negative also after confirmation with the Enzyme Linked Fluorescence Test. 5 out of the 9 patients were not born in the Netherlands. Since, 7 seronegative kidney transplantation candidates have been vaccinated with an attenuated life VZV-vaccine (OKA-strain Varilrix, 0,5 ml, GlaxoSmith Kline Beecham) twice with an interval of 6 weeks. Side effects were not observed. Serology was performed at 0, 6 and 13 weeks after the vaccination. 5 patients showed a seroconversion resulting in protective antibody levels, while 2 patients did not develop sufficient antibody titers against the virus. Conclusion: Of the patients on the waiting list for kidney transplantation approximately 3 % were seronegative for VZV and, therefore, at risk for severe problems after contact with chickenpox. Proportional more Dutch allochthones were contained in this group. Vaccination with an attenuated VZV resulted in a protective titer of anti-VZV antibodies in the majority of patients.