Immunization strategies for the immunocompromised host: the need for immunoadjuvants

Article Abstract:

The immunization of adults who have compromised immune systems (AIDS patients, patients receiving chemotherapy, transplant recipients and patients on dialysis) is a medical challenge. As the number of immunocompromised patients increases, the number of patients who could benefit from immunization also increases. Infection prevention is a high priority in immunocompromised patients. However, vaccines do not produce adequate responses in these patients, and stronger, more potent vaccines are needed. Immunomodulators are substances that help stimulate the host's immune response. Immunoadjuvants such as interleukins, interferons and growth factors are immunomodulators that increase the host's response to an administered antigen (foreign substance) such as a vaccine. Although these agents were originally manufactured in the laboratory to treat immunodeficiency disorders, they may be useful in enhancing the efficacy of vaccines. Research is desperately needed to study the safety, efficacy and optimal dosages of immunoadjuvants in immunocompromised patients. The elderly and very young, two groups of people having varying degrees of immune compromise, may especially benefit from immunoadjuvant therapy to enhance vaccine potency. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Complications and side effects, Physiological aspects, Immunological deficiency syndromes, Immunologic deficiency syndromes, Vaccines, Immunosuppression, Immunological tolerance, Immunologic tolerance, Immunologic adjuvants, editorial, Immunological adjuvants

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Preemptive ganciclovir therapy to prevent cytomegalovirus disease in cytomegalovirus antibody-positive renal transplant recipients: a randomized controlled trial

Article Abstract:

Preventive treatment with ganciclovir may reduce the rate of cytomegalovirus disease in kidney transplant recipients. Patients who test positive for cytomegalovirus are at high risk of infection, especially after transplantation. Researchers compared the incidence of cytomegalovirus disease in 64 kidney transplant recipients on ganciclovir therapy compared to 49 transplant recipients who did not receive ganciclovir (the control group). All 113 patients tested positive for cytomegalovirus and were receiving antilymphocyte antibody therapy. Only 14 percent of the patients taking ganciclovir developed cytomegalovirus disease compared to 33% of the control group. In addition, ganciclovir infusions caused no side effects during the time of administration.

Kidneys, Kidney transplantation, Ganciclovir

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Effect of cytomegalovirus infection status on first-year mortality rates among orthotopic liver transplant recipients

Article Abstract:

The presence of cytomegalovirus (CMV) in either a liver transplant donor or recipient appears to significantly affect the recipient's risk for death during the first year after transplant. CMV blood tests were performed on the donors and recipients of 146 liver transplants. Thirty-eight transplant recipients died within one year of transplant. The one-year mortality rates in those who received a liver from a CMV-positive donor were 30% to 44%, which was up to 4 times higher than the mortality rate in those who received a liver from a CMV-negative donr. No other risk factor measured before transplant had such a high correlation with death rates.

Patient outcomes, Mortality, Organ transplant recipients, Liver, Liver transplantation

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