Comparison of pneumococcal vaccination response in children with sickle cell disease: HbSS and HbSC
Allergol. immunopatol
; 47(6): 564-569, nov.-dic. 2019. graf, tab
Artigo
em Inglês
| IBECS
| ID: ibc-186549
Biblioteca responsável:
ES1.1
Localização: BNCS
ABSTRACT
Introduction:
Sickle cell disease (SCD) children are at increased risk of invasive pneumococcal disease and rely on penicillin prophylaxis and vaccination for infection prevention. Post-vaccination antibody levels in SCD may wane overtime. HbSC are believed to have better immunological response than HbSS.Objective:
To compare antibody response to 23-valent pneumococcal polysaccharide vaccine (PPSV-23) between HbSS and HbSC.Methods:
Patients with HbSS (n = 33) and HbSC (n = 11), aged 7-18 years, were prospectively recruited. Luminex pneumococcal antibody levels were measured for 23-serotypes, after two PPSV-23 doses.Results:
Absolute median titer for 20 of the 23 serotypes was higher in HbSC than HbSS and significantly higher for serotypes 22 (3.9 vs. 1.6mcg/ml; p=0.039) and 43 (2.9 vs. 0.8mcg/ml; p = 0.007). HbSC mounted a better immune anti-pneumococcal response compared to HbSS (≥ 1.3 mcg/ml) for 18 of 23 serotypes, albeit not significant for any of the serotypes. More HbSC (64%) than HbSS (42%) were good vaccine responders (p = 0.303). Two of 21 (10%) good vaccine responders and nine of 23 (39%) poor vaccine responders SCD participants subsequently developed acute chest syndrome or pneumonia (p = 0.036). None of the HbSC patients developed ACS after receiving PPSV-23. HbSS poor vaccine responders were at increased future recurrence risk for ACS (p = 0.003), pneumonia (p = 0.036) or both (p = 0.011), compared to good vaccine responders.Conclusion:
HbSC possess better pneumococcal vaccine response than HbSS. Poor vaccine response is concerning for future acute pulmonary events. Current vaccination strategy for SCD sub-types are lacking, therefore further study to evaluate utility of vaccine boosters is necessaryRESUMEN
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Espanha
Base de dados:
IBECS
Assunto principal:
Vacinas Pneumocócicas
/
Doença da Hemoglobina SC
/
Anemia Falciforme
Limite:
Adolescente
/
Criança
/
Feminino
/
Humanos
Idioma:
Inglês
Revista:
Allergol. immunopatol
Ano de publicação:
2019
Tipo de documento:
Artigo
Instituição/País de afiliação:
University of Texas Health Science Center/USA