G.C. de Gast

HERPES-VIRUS IMMUNITY AND ACUTE GRAFT-VERSUS-HOST DISEASE

The influence of pretransplant herpes-virus antibodies in 126 marrow-graft recipients and their HLA-identical (A, B, C, DR) sibling donors on the incidence of grades II-IV acute graft-versus-host disease (GVHD) was studied in relation to previously reported risk factors for GVHD. Logistic regression procedures were used to control for confounding factors. Increasing donor age (odds ratio 3.7 per decade; p = 0.02) and donor seronegativity for Epstein-Barr virus (EBV; odds ratio 10.1; p = 0.005) were associated with a high incidence of GVHD. Total rather than selective gastrointestinal decontamination (odds ratio 0.1; p = 0.004), donor seronegativity for herpes simplex virus (HSV; odds ratio 0.1; p = 0.003), and recipient EBV-seronegativity (odds ratio 0.05; p = 0.002) were associated with a low incidence of GVHD. Pretransplant EBV and HSV serology may thus contribute substantially to the estimation of the risk for GVHD.

Immunogencity of two versus three injections of inactivated hepatitis A vaccine in adults

AIM To investigate the immunogenicity of two versus three injections of inactivated strain CR326F-derived hepatitis A vaccine in healthy adults. METHODS Healthy adult volunteers (n = 105) at Utrecht University Hospital, The Netherlands, were randomly assigned to receive intramuscular injections (deltoid muscle) of 25 Units (U) at 0 and 6 months (group A, n = 53), or at 0, 2 and 6 months (group B, n = 52). Blood was drawn before and at various time points after vaccination for determination of serum antibody to hepatitis A (anti-HAV). RESULTS One month after the first injection, the seroconversion rates (> or = 10 mIU/ml, international units) were 88% for group A and 90% for group B. Only 2/ 103 (one in each group) showed IgM anti-HAV. One month after the second injection, seroconversion rates were 100% in both groups. At months 3, 6 and 7, anti-HAV geometric mean titers were significantly different because of the different vaccination schedules, but they were similar at months 1, 2 and 12. The anti-HAV geometric mean titer increase after the second injection was higher when the interval between the two doses was of longer duration. Anti-HAV titers of females were significantly higher than those of males and vaccinees < or = 30 years had higher titers than those > 30 years. CONCLUSIONS Two 25 U doses of the vaccine investigated given at 0 and 6 months, induce adequate anti-HAV titers in all adult healthy vaccinees and are as immunogenic as three doses given at 0, 2 and 6 months.