Can the response to 23-valent pneumococcal vaccine in splenectomised patients be predicted?

被引：5

作者：

Llupia, Anna ^{[1
]}

Vilella, Anna ^{[1
]}

Costas, Laura ^{[2
]}

Diez, Consolacion ^{[1
]}

Torres, Ferran ^{[3
,4
]}

Yaguee, Jordi ^{[5
]}

Masso, Montserrat ^{[5
]}

Munoz, Ana ^{[6
]}

Mensa, Josep ^{[6
]}

机构：

[1] Hosp Clin Barcelona, Prevent Med & Epidemiol Dept, E-08036 Barcelona, Catalonia, Spain

[2] IDIBELL, Inst Catala Oncol, Canc Epidemiol Res Programme, Infect & Canc Unit UNIC, Lhospitalet De Llobregat 08908, Catalonia, Spain

[3] Hosp Clin Barcelona, IDIBAPS, Stat & Methodol Support Unit USEM, E-08036 Barcelona, Catalonia, Spain

[4] Univ Autonoma Barcelona, Sch Med, Biostat Unit, E-08193 Barcelona, Catalonia, Spain

[5] Hosp Clin Barcelona, Dept Immunol, E-08036 Barcelona, Catalonia, Spain

[6] Hosp Clin Barcelona, Dept Infect Dis, E-08036 Barcelona, Catalonia, Spain

来源：

VACCINE | 2012年 / 30卷 / 13期

关键词：

Splenectomy; Streptococcus pneumoniae; Response to vaccination; POLYSACCHARIDE VACCINE; ANTIBODY-RESPONSES; IMMUNOGLOBULIN-G; TRAUMA PATIENTS; INFECTION; ADULTS; IGG; VACCINATIONS; LYMPHOMA;

D O I：

10.1016/j.vaccine.2011.09.073

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

The 23-valent pneumococcal vaccine has unequal effectiveness in splenectomised patients. We performed a longitudinal study (2005-2008) whose main objective was to characterize the profile of non-responders among splenectomised patients treated at our institution and identify potential predictive indicators of the response to the vaccine. The immune response was evaluated in 96 subjects. The proportion of responders was 70% (95% Cl: 60-78%). Immunosuppression (OR=3.19, 95% Cl 1.04-9.73) and the reason for splenectomy (hematologic neoplasia versus non-malignant hematologic diseases, OR=7.37, 95% CI 1.71-31.7) were independent predictors of non-response to vaccination. However, the positive predictive value of the model and the likelihood ratio for a positive result were low (PPV = 76.6%, 95% Cl 66.2-84.4%, LR(+)=1.41,95% Cl 1.08-1.86). We recommend determining the response to pneumococcal vaccine in these patients when possible. (C) 2011 Elsevier Ltd. All rights reserved.

引用

页码：2382 / 2386

页数：5

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