Date: Sunday, May 3, 2015
Session Time: 2:15pm-3:45pm
Presentation Time: 3:15pm-3:27pm
Location: Room 115- AB
Introduction: Herpes zoster (HZ) is the clinical manifestation of varicella zoster virus (VZV) reactivation and occurs more frequently in people with a suppressed immune system. We studied the incidence of HZ in a cohort of renal transplant recipients. Moreover we assessed the efficacy of vaccination to increase VZV IgG titres in kidney transplant candidates to comparable levels as in healthy persons.
Methods: In a cohort of 522 renal transplant recipients, transplanted between 2003-2008, incidence and complications of HZ were analysed up to July 31, 2013. In a prospective study, patients ≥50 years awaiting renal transplantation (n=23) were vaccinated with Zostavax®. Gender and age-matched kidney transplant donors (n=22) were included as controls. VZV-specific IgG titres were determined before, 1 and 3 months after vaccination.
Results: HZ prevalence was 21.3%. HZ incidence was 12.5 cases/1000 person years (PY) under immunosuppressive therapy (IS) in patients <50 years, and 22.7 cases/1000 PY in patients ≥50 years. HZ incidence in the general population is significantly lower (7-8 cases/1000 PY). Complications (bacterial infections, systemic dissemination, death) only occurred in HZ cases under IS. After vaccination, VZV-IgG titres significantly increased at 1 and 3 months compared to before vaccination in both patients (1 mo: p=0.0003, 3 mo: p=0.0006) and donors (1 mo: p=0.0002, 3 mo: p<0.0001). The increment in VZV-IgG titers from pre-vaccination to 1 and 3 months post vaccination was comparable between patients and donors. One patient had a mild HZ episode at 11 months post-transplantation (16 months post-vaccination).
Discussion: HZ incidence post renal transplantation is high. Remarkably, in contrast to hepatitis B vaccination, VZV vaccination equally increased virus specific IgG titres in patients with renal failure compared to healthy individuals. ESRD patients can be effectively vaccinated to prevent herpes zoster.
To cite this abstract in AMA style:Kho M, Weimar W, Boveé D, Boer-Verschragen M, Eijk Avander, Besouw Nvan. Vaccination to Prevent the High Herpes Zoster Incidence After Renal Transplantation [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/vaccination-to-prevent-the-high-herpes-zoster-incidence-after-renal-transplantation/. Accessed April 20, 2021.
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