Pneumococcal Vaccination: The Response of Patients with Alcoholic Liver Cirrhosis

Authors

  • Mauro Pirovino,

    Corresponding author
    1. Medizinische Klinik, Stadtspital Waid, Abteilung für Klinische Immunologic der Universitdt Zürich, Medizinische Klinik der Universität Zürich, Zürich, Switzerland and Research Laboratories, Merck, Sharpe and Dohme, Westpoint, Pennsylvania
    • M. Pirovino, M.D., Medizinische Universitätsklinik, Inselspital, CH-3010 Bern, Switzerland.
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  • Eva Lydick,

    1. Medizinische Klinik, Stadtspital Waid, Abteilung für Klinische Immunologic der Universitdt Zürich, Medizinische Klinik der Universität Zürich, Zürich, Switzerland and Research Laboratories, Merck, Sharpe and Dohme, Westpoint, Pennsylvania
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  • Peter J. Grob,

    1. Medizinische Klinik, Stadtspital Waid, Abteilung für Klinische Immunologic der Universitdt Zürich, Medizinische Klinik der Universität Zürich, Zürich, Switzerland and Research Laboratories, Merck, Sharpe and Dohme, Westpoint, Pennsylvania
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  • Stephan Arrenbrecht,

    1. Medizinische Klinik, Stadtspital Waid, Abteilung für Klinische Immunologic der Universitdt Zürich, Medizinische Klinik der Universität Zürich, Zürich, Switzerland and Research Laboratories, Merck, Sharpe and Dohme, Westpoint, Pennsylvania
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  • Josef Altorfer,

    1. Medizinische Klinik, Stadtspital Waid, Abteilung für Klinische Immunologic der Universitdt Zürich, Medizinische Klinik der Universität Zürich, Zürich, Switzerland and Research Laboratories, Merck, Sharpe and Dohme, Westpoint, Pennsylvania
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  • Martin Schmid

    1. Medizinische Klinik, Stadtspital Waid, Abteilung für Klinische Immunologic der Universitdt Zürich, Medizinische Klinik der Universität Zürich, Zürich, Switzerland and Research Laboratories, Merck, Sharpe and Dohme, Westpoint, Pennsylvania
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Abstract

Patients with cirrhosis have an increased risk of dying from pneumococcal pneumonia. Their immunological response to pneumococcal vaccination is not known. We compared the antibody response to challenge with a 14-valent purified pneumococcal polysaccharide vaccine in 15 patients with biopsy-proven alcoholic liver cirrhosis, 10 healthy volunteers and 10 patients with chronic obstructive pulmonary disease. Preimmunization levels for Danish type 1 pneumococcal polysaccharide were lower among cirrhotics than patients with chronic obstructive pulmonary disease. Four and 12 weeks after immunization, no significant differences were found in antibody concentrations between the three groups. We conclude that patients with alcoholic cirrhosis can produce an adequate antibody response to pneumococcal polysaccharide antigen.

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