Source: International Congress 2015 – Advances from translational research in respiratory infections
Disease area: Respiratory infections

Abstract

Introduction:Haemophilus influenzae type b (Hib) may cause respiratory and systemic disease; it is associated with COPD exacerbation. Hib vaccination is advised in children, and in adults at risk of invasive disease. Aims:To assess (i)physician action following request of Hib antibody levels and (ii)the effect of vaccination on patient outcome. Methods:573 respiratory patients had specific Hib antibody assays between 01.06.2011 and 31.05.2013. Hospital data on 47.8% (n=274) with an inadequate baseline response were reviewed. Patients were divided into responders (normal response to vaccination) and non-responders (< doubling of baseline and/or value <1.0mcg/ml). Patients' wellbeing was assessed via telephone interview and number of antibiotic courses prescribed pre- and post-vaccination. Results: 49.6% (n=136) with an inadequate baseline antibody response were not vaccinated. Of those who were 105 (38.3%) were true responders. Of the 33 patients with an inadequate 2^nd antibody level only 18 had been re-vaccinated (true non-responders). 13/18 patients were re-tested, 4 had an inadequate 3^rd assay post 2^nd vaccination.

	Responders (post vaccination)		Non-responders (post vaccination)
	Subjective respiratory health (%)	Number of antibiotic courses (%)	Subjective respiratory health (%)	Number of antibiotic courses (%)
Improved	36.4	54.4	21.4	21.4
No change	54.5	27.3	57.2	35.7
Worse	9.1	18.2	21.4	42.9

 

Conclusion:Physician action is poor following detection of an inadequate Hib antibody response. Vaccination responders may have reduced need for antibiotics and improved symptoms compared to non-responders. Exploration of these findings is needed.


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Citations should be made in the following way:
Helen Davies (Cardiff, United Kingdom), S.M. White, H.E. Davies. Management of patients with an inadequate haemophilus influenzae type b antibody response. Eur Respir J 2015; 46: Suppl. 59, 5030

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