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Haemophilus influenzae type b immunization in infants on peritoneal dialysis. Pediatric Peritoneal Dialysis Study
A M Neu1, H M Lederman, B A Warady
1Division of Pediatric Nephrology, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA.
Insights
Most infants on chronic peritoneal dialysis (CPD) develop protective antibody levels after Haemophilus influenzae type b (Hib) immunization. However, vaccine failure occurred in some, and long-term antibody maintenance requires further study.
Area of Science:
- Immunology
- Pediatrics
- Nephrology
Background:
- Chronic peritoneal dialysis (CPD) is a treatment for pediatric kidney failure.
- Immunocompromised patients may have altered responses to vaccines.
- Haemophilus influenzae type b (Hib) is a significant pathogen in young children.
Purpose of the Study:
- To evaluate the immunogenicity of Haemophilus influenzae type b (Hib) vaccine in infants on chronic peritoneal dialysis (CPD).
- To assess the development and maintenance of protective antibody levels post-Hib immunization in this population.
Main Methods:
- A multi-center study measured antibody levels to Hib in ten infants (≤39 months) undergoing CPD.
- Immunization with Hib vaccine was administered during CPD treatment.
- Serial antibody measurements were performed in a subset of patients.
Main Results:
- Nine out of ten infants achieved protective antibody levels against Hib.
- All four patients with serial measurements maintained protective levels, though two showed a decrease.
- Most, but not all, infants demonstrated an adequate immune response.
Conclusions:
- Hib vaccination is largely effective in infants on CPD.
- Factors contributing to vaccine failure in some infants require further investigation.
- Long-term antibody persistence following Hib vaccination in CPD patients needs to be determined.
Abstract:
As part of a multi-center collaborative study, we measured antibody levels to Haemophilus influenzae type b (Hib) in ten chronic peritoneal dialysis (CPD) patients, aged 39 months or less, who were immunized while on CPD. Nine of the ten developed protective antibody levels to Hib. Four patients had serial measurements of antibody and all maintained protective levels, although the levels did decrease in two patients. Thus most, but not all, infants immunized with Hib vaccine while on CPD develop protective antibody levels. The factors responsible for vaccine failure are not clear. Whether patients maintain protective antibody over time needs to be determined.