Arnaud G LʼHuillier1, Cedric Hirzel, Victor H Ferreira, Matthew Ierullo, Terrance Ku, Nazia Selzner, Jeffrey Schiff, Stephen Juvet, Congrong Miao, D Scott Schmid, Atul Humar, Deepali Kumar. 1. 1 Pediatric Infectious Diseases Unit, Geneva University Hospitals and Faculty of Medicine, 4 rue Gabrielle-Perret-Gentil, 1211 Geneva 4, Switzerland 2 Division of Infectious Diseases, Inselspital, Freiburgstrasse 18, 3010 Bern, Switzerland 3 Ajmera Transplant Centre, University Health Network, 585 University Avenue, Toronto, Ontario M5G 2N2, Canada 4 Centers for Disease Control and Prevention, Division of Viral Diseases, 1600 Clifton Road, Atlanta, GA 30333, USA.
Abstract
BACKGROUND: Immunization of VZV-seronegative solid organ transplant (SOT) patients using the live-attenuated varicella vaccine is generally contraindicated, leaving no widely applicable immunization option. The recombinant subunit herpes zoster vaccine (RZV) is indicated for VZV seropositive persons to prevent shingles but could potentially also protect VZV-seronegative persons against varicella. We performed a safety and immunogenicity evaluation of RZV in VZV-seronegative SOT recipients as an option for protection. METHODS: VZV-seronegative adult SOT patients with no history of varicella/shingles vaccine or disease were given 2 doses of RZV vaccine 2-6 months apart. Blood was drawn prevaccination (V1), prior to the second dose (V2) and 4 weeks after second dose (V3). Humoral (anti-gE) and cell-mediated immunity was evaluated, with polyfunctional cells defined as cells producing ≥2 cytokines. RESULTS: Among 31 eligible VZV-seronegative SOT patients screened, 23 were enrolled. Median age was 38 years and median time since transplant procedure was 38 years. The most frequent transplant types were liver (35%) and lung (30%). Median anti-gE levels significantly increased from V1 to V3 (p=0001) and V2 to V3 (p<0001), even though only 55% had a positive seroresponse. Median polyfunctional CD4 T-cells counts increased from V1 to V2 (54/10 vs 104/10 cells; p=0041), and from V2 to V3 (380/10; p=0002). Most adverse events were mild with no rejection episodes. CONCLUSION: RZV was safe and elicited significant humoral and cellular responses in VZV-seronegative SOT patients, and has the potential to be considered as a preventive strategy against primary varicella.
BACKGROUND: Immunization of VZV-seronegative solid organ transplant (SOT) patients using the live-attenuated varicella vaccine is generally contraindicated, leaving no widely applicable immunization option. The recombinant subunit herpes zoster vaccine (RZV) is indicated for VZV seropositive persons to prevent shingles but could potentially also protect VZV-seronegative persons against varicella. We performed a safety and immunogenicity evaluation of RZV in VZV-seronegative SOT recipients as an option for protection. METHODS: VZV-seronegative adult SOT patients with no history of varicella/shingles vaccine or disease were given 2 doses of RZV vaccine 2-6 months apart. Blood was drawn prevaccination (V1), prior to the second dose (V2) and 4 weeks after second dose (V3). Humoral (anti-gE) and cell-mediated immunity was evaluated, with polyfunctional cells defined as cells producing ≥2 cytokines. RESULTS: Among 31 eligible VZV-seronegative SOT patients screened, 23 were enrolled. Median age was 38 years and median time since transplant procedure was 38 years. The most frequent transplant types were liver (35%) and lung (30%). Median anti-gE levels significantly increased from V1 to V3 (p=0001) and V2 to V3 (p<0001), even though only 55% had a positive seroresponse. Median polyfunctional CD4 T-cells counts increased from V1 to V2 (54/10 vs 104/10 cells; p=0041), and from V2 to V3 (380/10; p=0002). Most adverse events were mild with no rejection episodes. CONCLUSION: RZV was safe and elicited significant humoral and cellular responses in VZV-seronegative SOT patients, and has the potential to be considered as a preventive strategy against primary varicella.
Authors: Victor H Ferreira; Tina Marinelli; Matthew Ierullo; Terrance Ku; Victoria G Hall; Beata Majchrzak-Kita; Vathany Kulasingam; Atul Humar; Deepali Kumar Journal: J Infect Dis Date: 2021-12-01 Impact factor: 5.226
Authors: Isabel Leroux-Roels; Gwenn Waerlop; Jessika Tourneur; Fien De Boever; Catherine Maes; Jacques Bruhwyler; Delphine Guyon-Gellin; Philippe Moris; Judith Del Campo; Paul Willems; Geert Leroux-Roels; Alexandre Le Vert; Florence Nicolas Journal: Front Immunol Date: 2022-04-07 Impact factor: 8.786