The immunogenicity of Haemophilus influenzae type b conjugate vaccines in children born to human immunodeficiency virus-infected women

• Published in: The Pediatric infectious disease journal Vol. 17; no. 5; pp. 391 - 397
• Main Authors: READ, JENNIFER S, FRASCH, CARL E, RICH, KENNETH, FITZGERALD, GORDON A, CLEMENS, JOHN D, PITT, JANE, PELTON, STEPHEN I, HANSON, I CELINE, HANDELSMAN, EDWARD, DIAZ, CLEMENTE, FOWLER, MARY GLENN
• Format: Journal Article
• Language: English
• Published: Baltimore, MD Williams & Wilkins 01-05-1998; Philadelphia, PA Lippincott; Hagerstown, MD
• Subjects: Biological and medical sciences; Epidemiology. Vaccinations; General aspects; Infectious diseases; Medical sciences; Human; Immunopathology; Vaccination; AIDS; Vaccine; Immune deficiency; Mother to child transmission; Haemophilus influenzae; Infection; Pasteurellaceae; Prevention; Immunoprophylaxis; Immunogenicity; Mother; Viral disease; Bacteria; Complication; Child
• ISSN: 0891-3668; 1532-0987
• DOI: 10.1097/00006454-199805000-00009

BACKGROUND.Immunocompromise caused by HIV-1 infection increases the importance of receipt of routine childhood vaccines to prevent infections such as invasive Haemophilus influenzae type B (Hib) disease. The objectives of the study were to evaluate the immunogenicity of Hib conjugate vaccines among HIV-infected children according to clinical and immunologic disease progression as well as viral load.
METHODS.The concentration of antibody to polyribosylribitol phosphate (PRP) was measured at ∼9 and 24 months of age in plasma specimens from children of HIV-infected women enrolled in the Women and Infants Transmission Study.
RESULTS.Among 227 children (35 HIV-infected, 192 uninfected) at the 9-month study visit who were known to have received age-appropriate immunization with CRM197 mutant Corynebacterium diphtheriae protein-conjugated Hib vaccine, geometric mean antibody concentrations were lower among HIV-infected children (1.64 μg/ml) than among uninfected children (2.70 μg/ml), although the difference was not statistically significant. Anti-PRP antibody concentrations did not vary significantly among these HIV-infected children with predominantly mild-moderate disease progression according to clinical category, immunologic stage or viral load (P ≥ 0.48). The proportion of children with antibody concentrations ≥1.0 μg/ml did not vary significantly according to HIV infection status (73% uninfected, 74% infected) or, if infected, clinical or immunologic disease progression or viral load. Similar results were obtained among 127 children (17 HIV-infected, 110 uninfected) eligible for analysis at the 24-month study visit. Changes in antibody concentrations over time (between 9 and 24 months of age) did not differ significantly among 10 HIV-infected as compared with 72 uninfected children (P = 0.81).
CONCLUSIONS.These results suggest that HIV-infected children with predominantly mild-moderate disease progression respond reasonably well in terms of a quantitative antibody response to Hib conjugate vaccines during the first 2 years of life. Research to further characterize the immune response to Hib conjugate vaccines and to further delineate the "durability" of anti-PRP antibody concentrations beyond 2 years of life should be pursued.