Immune Response to Haemophilus influenzae Type b Vaccination in Patients with Chronic Renal Failure

Adult chronic renal failure patients undergoing hemodialysis are at an increased risk of invasive Haemophilus influenzae type b (Hib) disease due to the lack of functionally active anti-Hib antibodies. The pediatric Hib polysaccharide-protein conjugate vaccine is highly immunogenic in these patients and can provide protection against invasive Hib infection for at least 1 year. Haemophilus influenzae type b (Hib) was the major cause ofbacterial meningitis in children worldwide before the intro-duction of the conjugate Hib vaccine in the late 1980s. Since then, the incidence of invasive Hib disease has dramatically declined in all countries where this vaccine was included into public immu-nization programs (13). The vaccine stimulates production of anti-Hib capsular polysaccharide antibodies, which trigger com-plement-dependent killing and phagocytosis of bacteria (17). In unvaccinated individuals, protection against Hib is mediated by natural antibodies induced byHib carriage and exposure to cross-reactive bacteria (8, 12). Chronic renal failure (CRF), i.e., the end-stage kidney diseas