June 06, 2016
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Total IgG, B cell counts predicted infection risk in patients with systemic vasculitis

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Researchers of this study used total immunoglobulin G and B cell counts to identify the risk of infection for patients with systemic vasculitis in remission.

“Using these biomarkers as risk stratification may allow identification of patients who may benefit from immunosuppression withdrawal if appropriate and/or the use of additional therapies, such as [intravenous immunoglobulin] IVIG, as a way to reduce infection and mortality,” Matthew D. Morgan, MB ChB, MRCP, PhD, from the University of Birmingham College of Medical and Dental Sciences in Birmingham, United Kingdom, and colleagues wrote in their study.

Morgan and colleagues evaluated 92 patients who received pneumococcal 7-valent conjugate, Haemophilus influenzae type b, and meningococcal group C conjugate vaccine at baseline and meningococcal polysaccharide groups A, C, and Y, and W135 vaccines 4 weeks later, according to the abstract. Immediately prior to vaccination, the researchers determined antibody titers for specific antigens and collected blood from patients to analyze baseline lymphocytes and total immunoglobulin G (IgG) levels. Antibody titers were also measured at 4 weeks and 2 years after vaccination to determine an antibody response score. The median follow-up for all patients was 4.6 years.

The researchers found 18 patients died at median 2-year follow-up, and there was an infection rate of 0.4 infections per patient, per year, according to the abstract. While serum IgG, CD4+ cell count and B cell count predicted a poor vaccine response, the researchers found these did not predict mortality. However, factors such as age, reduced renal function and vaccine response predicted all-cause mortality. The researchers noted there was a highly variable response rate to individual vaccine antigens, with a median response rate of 46% for each individual response to an antigen. – by Jeff Craven

Disclosures: Richter has received consulting fees, speaking fees and/or honoraria from Pfizer, and Goldblatt has received consulting fees, speaking fees and/or honoraria from GlaxoSmithKline, Merck, Novartis, Pfizer and Sanofi Pasteur.