Bootcongres

Introduction: Reactivation of varicella zoster virus (VZV) results in herpes zoster, more frequently occurring in elderly people and transplant recipients. Previously, we demonstrated that VZV-specific IgG titres were significantly lower after compared to before transplantation. In addition, VZV-reactive memory T-cells are significantly lower in transplant recipients compared to healthy individuals. Zostavax® is licensed to boost VZV immunity in individuals aged 50 years or older, aiming to reduce herpes zoster associated morbidity. We assume that VZV vaccination before transplantation boosts the patient’s B-cell response, thereby reducing the incidence of herpes zoster after transplantation. However, the effect of a VZV booster in renal failure patients is unknown. Materials and methods: Patients (n=8), ≥ 50 years, waiting for renal transplantation were vaccinated with Zostavax®. Gender and age-matched kidney transplant donors (n=8) were included as controls for the response of healthy individuals. Before, 1, 3 and 12 months after vaccination VZV-specific IgG titres were measured. Results: VZV-IgG titres were significantly increased at 1 month post vaccination in both patient (p=0.008) and donors (p=0.008). Between 1 month and 3 months post vaccination, VZV-IgG titres decreased significantly in patients (p=0.02) and donors (p=0.02). However, 3 months post vaccination the titres in both patients (p=0.008) and donors (p=0.02) were still significantly higher than before vaccination. The increment between pre-vaccination and 1 month and 3 months post vaccination was comparable between patients and donors. No adverse events were reported after vaccination. Conclusion: This pilot study demonstrates that the B-cell response in patients with renal failure increases at similar levels as in healthy individuals after a VZV booster.