Pneumococcal Vaccine Response in Cirrhosis and Liver Transplantation

• Published in: The Journal of infectious diseases Vol. 181; no. 2; pp. 757 - 760
• Main Authors: McCashland, T. M., Preheim, L. C., Gentry-Nielsen, M. J.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01-02-2000; University of Chicago Press; Oxford University Press
• Subjects: Adult; Antibodies; Antibodies, Bacterial - blood; Bacterial Vaccines - administration & dosage; Bacterial Vaccines - immunology; Bacteriology; Biological and medical sciences; Cirrhosis; Concise Communications; Enzyme linked immunosorbent assay; Female; Fundamental and applied biological sciences. Psychology; Humans; Liver Cirrhosis - immunology; Liver diseases; Liver transplantation; Liver Transplantation - immunology; Male; Matched-Pair Analysis; Microbiology; Middle Aged; Pneumococcal Infections - prevention & control; Pneumococcal vaccine; Pneumococcal Vaccines; Polysaccharides; Statistical significance; Streptococcus pneumoniae; Transplantation; Vaccination; Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies; Immune response; Digestive system; Antibody; Liver; Vaccination; Hepatic disease; Transplantation; Vaccine; Streptococcus pneumoniae; Infection; Streptococcaceae; Cirrhosis; Immunoprophylaxis; Streptococcal infection; Bacteriosis; Digestive diseases; Bacteria; Micrococcales; Pneumococcal infection; Humoral immunity; Quantitative analysis
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/315245

Cirrhosis is a major risk factor for severe pneumococcal infection, and patients evaluated for liver transplantation routinely receive pneumococcal vaccine. This study followed serologic antibody levels of 45 adults evaluated for transplantation and 13 age-matched control subjects. All received 23-valent pneumococcal polysaccharide vaccine (PPS). Serum anti-PPS levels and antibodies specific for capsular types 3 and 23 were measured by ELISA before and 1 and 6 months after vaccination. Antibody levels for the 25 patients who received transplants also were measured immediately before and 3 months after transplantation. Control subjects had higher IgG responses to the whole vaccine, whereas patients appeared to produce more IgM and IgA. IgA, and possibly IgM levels, also declined faster in patients than in control subjects. All anti-PPS levels were at or below prevaccination baselines by 3 months after transplantation. These data suggest that vaccination with PPS may not be effective for patients during and after liver transplantation.