Influenza subtype-specific IgA, IgM and IgG responses in patients on hemodialysis after influenza vaccination

The isotype-specific antibody response to influenza vaccination in 36 patients undergoing chronic intermittent hemodialysis was analyzed by an influenza subtype-specific immunofluorescence test. The immune response was recorded at regular intervals over five months. On the basis of fourfold IgG titer rises as the classical parameter protection from infection was assumed to occur in more than 85% of healthy adults to each of the influenza antigens. In contrast, about 70% of the patients on hemodialysis had responded to influenza A H1N1 and H3N2 vaccines while only 50% of the patients on hemodialysis had responded to influenza B antigen. However, patients showed decreased rates and lower peak responses in IgA, IgM and IgG antibodies to influenza A and B antigens. Probably as a result of the underlying renal disease the different kinetics of antibody responses and the lower influenza specific immunoglobulin levels resulted in lower seroconversion rates in hemodialysis patients compared to those in healthy volunteers.