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P557. Antibody and cell-mediated immune response to whole virion and split virion influenza vaccine in patients with inflammatory bowel disease on maintenance immunosuppressive and biological therapy

A. Balint1, K. Farkas1, É. Pallagi-Kunstár1, G. Terhes2, E. Urbán2, M. Szucs3, T. Nyári3, Z. Bata4, F. Nagy1, Z. Szepes1, P. Miheller5, K. Lorinczy5, P.L. Lakatos6, B. Lovász6, T. Szamosi7, A. Kulcsár8, A. Berényi1, D. Torocsik1, T. Daróczi1, Z. Saródi1, T. Wittmann1, T. Molnár1, 1University of Szeged, First Department of Medicine, Szeged, Hungary, 2University of Szeged, Institute of Clinical Microbiology, Szeged, Hungary, 3University of Szeged, Department of Medical Physics and Informatics, Szeged, Hungary, 4University of Szeged, Department of Dermatology and Allergology, Szeged, Hungary, 5Semmelweis University, 2nd Department of Medicine, Budapest, Hungary, 6Semmelweis University, 1st Department of Medicine, Budapest, Hungary, 7National Medical Center, Department of Internal Medicine, Budapest, Hungary, 8Integrated Szent Istvan and Szent László Hospital, Integrated Szent Istvan and Szent László Hospital, Budapest, Hungary

Background

Influenza vaccination is recommended for inflammatory bowel disease (IBD) patients on immunosuppressive therapy. The objectives of this study were to evaluate and compare the antibody and cell-mediated immune response to the split and whole virion influenza vaccine in patients with IBD treated with anti-TNF-alpha and immunosuppressive therapy.

Methods

156 immuncompromised IBD patients were vaccinated. 53 patients (control group) refused vaccination. Split virion vaccine and whole virion vaccine were used. Serum samples were obtained for pre- and postimmunisation antibody titers to influenza vaccine (A/California/7/2009 (H1N1), A/Victoria/361/2011 (H3N2), B/Wisconsin/1/2010-like B/Hubei-Wujiagang/158/2009). Cell-mediated responses were evaluated using an interferon (INF)-gamma, interleukin (IL)-2, and tumor necrosis factor (TNF)-alpha ELISA.

Results

Postimmunisation titers of both influenza subtypes increased significantly after the administration of split virion vaccines compared to the controls and to those who received whole virion vaccine. The antibody titers of Influenza B also increased significantly in patients immunized with split vaccine and treated with anti TNF-alpha therapy. After influenza vaccination the level of serum IL-2 significantly decreased. No serious side-effect developed after influenza vaccination, influenza-like symptoms did not differed significantly between vaccinated vs. control patients. The relapse of the disease was observed in only 10% of the patients that was more common in vaccinated vs. control subjects.

Conclusion

Split vaccines seem to be more effective than whole virion vaccines. Measuring the antibody responses is worth in patients treated with immunosuppressants to determine the efficacy of influenza vaccination.