Особенности вакцинации против гемофильной инфекции типа b пациентов листа ожидания трансплантации легких

Abstract

Objective: to evaluate the immunological efficacy of haemophilus influenzae type b ( Hib ) vaccine in patients with\xa0severe bronchopulmonary condition waitlisted for lung transplantation. Materials and methods. 16 patients (age\xa022–61 years) with severe bronchopulmonary diseases were vaccinated once against Hib infection. IgG antibody\xa0concentrations to Hib capsular polysaccharide before vaccination and 1 month after was measured by ELISA\xa0using a test system developed at Mechnikov Research Institute of Vaccines and Sera. Statistical data processing\xa0was carried out using stats (v.3.6.2), lme4 (v.1.1 – 21), and lmerTest (v.3.1 – 1) packages. Results. Hib vaccine in\xa0patients with severe bronchopulmonary condition did not elicit any local or systemic reactions. The proportion of\xa0patients whose antibody (Ab) concentrations to Hib capsular polysaccharide exceeded the long-term protection\xa0threshold was 69% and 100% before and after vaccination, respectively (p = 0.02). There were differences in the\xa0formation of post-vaccination immunity depending on the nosological forms of patients’ diseases. In the group of\xa0patients with obstructive pulmonary diseases, the geometric mean level of antibodies to the Hib capsular polysaccharide after vaccination increased as compared to the baseline\xa0 value – from 1.3 [0.6–2.8] to 5.5 [1.9–15.4] AU/mL, (p = 0.05). In the group of patients with restrictive lung diseases, the level did not change – 2.8 [0.6–14.1]\xa0AU/mL before vaccination and 3.4 [1.3–8.5] AU/mL 1 month after vaccination. In the group of patients taking\xa0glucocorticosteroids, there was no increase in the level of antibodies to Hib capsular polysaccharide (2.7 [0.8–9.3]\xa0AU/mL before and 2.8 [1.2–6.5] AU/mL after vaccination). In the group of patients who did not take hormones,\xa0antibody concentrations to Hib capsular polysaccharide increased from 1.2 [0.7–2.1] AU/mL to 4.8 [2.2–10.1]\xa0AU/mL (p = 0.006). Conclusion. Hib vaccination of waitlisted patients with severe bronchopulmonary disease\xa0is safe and immunologically effective.