3.3 Influenza A/H1N1 vaccination and MICA immunisation

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3.3 Influenza A/H1N1 vaccination and MICA immunisation

In 2009, a novel influenza A (H1N1) virus, sharing antigenic similarity with swine influenza viruses, caused a pandemic, which has lead to a wide vaccination campaign in the United States and Europe.

Since there was no data regarding neither the immunogenicity nor the safety of Influenza A/H1N1-adjuvanted vaccine in CKD patients, we decided to measure the neutralizing antibodies against Influenza A/H1N1/2009 vaccine and to determine the seroconversion rate in sera from 21 controls, 53 haemodialyzed patients and 111 renal transplant recipients taken before and 1 month after a single dose of Pandemrix vaccine (GSK Biologicals, AS03-adjuvanted). In addition, we analyzed HLA and MICA immunisation using Luminex beads coated with recombinant HLA and MICA antigens before and 1 month after vaccination.

The geometric mean titer ratio was 38, 9 and 5 for controls, haemodialysed

patients and kidney transplant recipients, respectively (p<0.0001). The proportion

of responders was 90%, 57% and 44%, respectively (p<0.0001). In renal

transplanted patients, the frequency of HLA and MICA immunisation was similar

before and after vaccination. Only 2 patients, one haemodialyzed and one renal

transplant recipient, developed de novo anti-HLA class II antibodies. Among the

16 renal transplanted patients sensitized against MICA before vaccination

(14.4%), only 8 remained positive at 1 month after vaccination while 4 patients

developed de novo MICA antibodies. No serious event related to vaccination was

reported during the study. No AR episode was observed in transplanted patients,



and their kidney graft function remained stable during the 6 months after vaccination.

We concluded that Influenza A/H1N1-adjuvanted vaccine was efficient and safe

in CKD patients but as compared to healthy people, the humoral response was

poor in haemodialysed and even more in transplanted patients.




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