Antibody response to Haemophilus influenzae type-b conjugate vaccine in children and young adults with congenital asplenia or after undergoing splenectomy

• Published in: European journal of clinical microbiology & infectious diseases 2012-05, Vol.31 (5), p.805-809
• Main Authors: Mikoluc, B., Motkowski, R., Käyhty, H., Heropolitanska-Pliszka, E., Pietrucha, B., Bernatowska, E.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Antibodies; Antibodies, Bacterial - blood; Antibody response; Asplenia; Bacteria; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Child; Child, Preschool; Children; Congenital diseases; Disease; Enzyme-Linked Immunosorbent Assay; Enzymes; Haemophilus influenzae; Haemophilus influenzae type b - immunology; Haemophilus Vaccines - administration & dosage; Haemophilus Vaccines - immunology; Health risks; Humans; Immune response; Immunization; Immunologic Memory; Immunology; Infection; Infectious diseases; Internal Medicine; Liver, biliary tract, pancreas, portal circulation, spleen; Medical Microbiology; Medical sciences; Patients; Spleen; Spleen - abnormalities; Splenectomy; Streptococcus infections; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Vaccination; Vaccines; Vaccines, Conjugate - administration & dosage; Vaccines, Conjugate - immunology; Young Adult; Young adults
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s10096-011-1378-8

Absence of the spleen constitutes a risk of infection caused by encapsulated bacteria. The aim of our study was to determine the immune response to Haemophilus influenzae type-b (Hib) conjugate vaccine (HibCV) in asplenic individuals, considering the cause of asplenia, the age when splenectomy was carried out, and previous Hib vaccinations. Twenty asplenic patients, aged five to 25 years, were immunized with a single dose of HibCV. The specific antibody concentrations against HibCV were measured by enzyme-linked immunosorbent assay. Before vaccinations, the geometric mean antibody concentration (GMC) had an average value of 3.21 μg/ml and was comparable for all of the patients, regardless of the causes of asplenia. After vaccinations, the GMC was significantly higher, with an average of 6.78 μg/ml. Further, 4.5 years after vaccinations, the GMC was comparable to that of previously unvaccinated children. Moreover, 17/20 patients had GMC ≥ 1.0 μg/ml, which included all of the children with congenital asplenia, children splenectomized before the age of six years, and only 57% of children splenectomized after that age. HibCV gives asplenic patients long-term protection. Hence, HibCV should be administered regardless of previous vaccinations and time from splenectomy, even if antibody evaluation is not available.