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

Autor(es)

Barbosa, C. M. P. L. ^[1] ; Terreri, M. T. R. A. ; Rosario, P. O. ^[2] ; de Moraes-Pinto, M. I. ^[2] ; Silva, C. A. A. ^[3] ; Hilario, M. O. E.

Afiliação do(s) autor(es)

^[1] Univ Fed Sao Paulo, Disciplina Alergia Imunol Clin & Reumatol, Dept Pediat, BR-04025002 Sao Paulo - Brazil

^[2] Univ Fed Sao Paulo, Div Paediat Infect Dis, Dept Pediat, BR-04025002 Sao Paulo - Brazil

^[3] Univ Sao Paulo, Childrens Inst, Dept Paediat, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: CLINICAL AND EXPERIMENTAL RHEUMATOLOGY; v. 30, n. 5, p. 791-798, SEP-OCT 2012.
• Citações Web of Science: 18

Resumo

Objectives The 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. Methods We 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. Results We 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. Conclusion The 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. (AU)

• Processo FAPESP: 05/55003-8 - Vacina anti-varicela em crianças e adolescentes com lúpus eritematoso sistêmico (LES): imunogenicidade e segurança
• Beneficiário: Maria Odete Esteves Hilário
• Modalidade de apoio: Auxílio à Pesquisa - Regular