Immune response and tolerability of varicella vaccine in children and adolescents with systemic lupus erythematosus previously exposed to varicella-zoster virus

Immune response and tolerability of varicella vaccine in children and adolescents with systemic lupus erythematosus previously exposed to varicella-zoster virus

Author Barbosa, Cassia Maria Passarelli Lupoli Autor UNIFESP Google Scholar
Terreri, Maria Teresa Ramos Ascensão Autor UNIFESP Google Scholar
Rosario, P. O. Autor UNIFESP Google Scholar
Moraes-Pinto, Maria Isabel de Autor UNIFESP Google Scholar
Silva, C. A. A. Google Scholar
Hilário, Maria Odete Esteves Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
Abstract ObjectivesThe aim of the present paper is to evaluate the immune response and tolerability of varicella vaccine in children and adolescents with systemic lupus erythematosus previously exposed to varicella-zoster virus.MethodsWe performed a prospective and controlled study on a group of 54 SLE patients that were chosen at random to be or not to be vaccinated (28 were vaccinated and 26 were not). Twenty-eight healthy controls, of matching age and sex were also vaccinated. All were submitted to a questionnaire, physical evaluation and laboratory assays: lymphocyte immuno-phenotyping by flow cytometry, plasma varicella zoster virus (VZV) serology by ELISA and in vitro interferon gamma (IFN gamma) production by T-cells after stimulus with VZV antigen. They were evaluated before vaccination and at 30, 45, 180 and 360 days afterwards.ResultsWe did not observe any differences in the frequency of adverse events in both vaccinated groups. At study entry, all individuals were seropositive for VZV antibodies. The serum VZV antibody titres similarly increased after vaccination. The frequency of flares and the SLEDAI score were also similar among the patients. Thirty days after vaccination the production of IFN gamma specific to VZV was lower in the SLE group compared to healthy, controls. In the follow-up we observed 4 cases of herpes zoster in the SLE unvaccinated group, but no zoster in the vaccinated group.ConclusionThe varicella vaccine was well tolerated in SLE group, who had pre-existing immunity to varicella. The varicella vaccine immunogenicity measurement by serum antibody titres was appropriate. The incidence of HZ was lower in the vaccinated lupus group.
Keywords herpes zoster
immunocompromised host
systemic lupus erythematosus
vaccine
varicella
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Grant number FAPESP: 05/55003-8
Date 2012-09-01
Published in Clinical And Experimental Rheumatology. Pisa: Clinical & Exper Rheumatology, v. 30, n. 5, p. 791-798, 2012.
ISSN 0392-856X (Sherpa/Romeo, impact factor)
Publisher Clinical & Exper Rheumatology
Extent 791-798
Origin http://www.clinexprheumatol.org/abstract.asp?a=5209
Access rights Closed access
Type Article
Web of Science ID WOS:000310828600024
URI http://repositorio.unifesp.br/11600/43332

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