Antibody responses to Haemophilus influenzae type B vaccines in men with human immunodeficiency virus infection.
BACKGROUND
Persons with human immunodeficiency virus (HIV) infection are at increased risk for serious infections caused by Haemophilus influenzae, yet there are few data on their antibody responses to the H. influenzae type b vaccines.


METHODS
We evaluated antibody responses in 248 men who were randomly assigned to receive a single dose of either the H. influenzae type b polysaccharide (PRP) vaccine or the polysaccharide-mutant diphtheria toxoid conjugate vaccine (PRP-CRM). The subjects were stratified into four groups: seronegative men (67 subjects), men with asymptomatic HIV infection (79), men with symptomatic HIV infection (47), and men with the acquired immunodeficiency syndrome (AIDS) (55).


RESULTS
Before immunization, the subjects with AIDS had the lowest PRP-antibody titers; 40 percent had titers below the putative protective level (less than 0.15 micrograms per milliliter). In the seronegative subjects, those with asymptomatic HIV infection, and those with symptomatic HIV infection, the PRP-CRM vaccine led to a threefold greater increase in geometric mean antibody titers than did the PRP vaccine (P less than 0.01). However, the subjects with AIDS had a greater antibody response to the PRP vaccine. The antibody response of HIV-seropositive men to the PRP-CRM vaccine correlated significantly with the number of CD4 lymphocytes (r = 0.47, P less than 0.0001, as compared with r = -0.01 for the PRP vaccine). In these HIV-infected men, both vaccines elicited the dominant anti-PRP idiotype described previously in populations not infected with HIV.


CONCLUSIONS
Immunization with the PRP-CRM conjugate vaccine early in the course of HIV infection is likely to confer protection against disease caused by H. influenzae type b.
Department of International Health, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD 21205.
M C
MC
Steinhoff
B S
BS
Auerbach
K E
KE
Nelson
D
D
Vlahov
R L
RL
Becker
N M
NM
Graham
D H
DH
Schwartz
A H
AH
Lucas
R E
RE
Chaisson
D016915:AIDS Vaccines / Q000276:immunology*; D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology; D000328:Adult; D000907:Antibodies, Bacterial / Q000032:analysis; D000917:Antibody Formation; D001428:Bacterial Vaccines / Q000276:immunology*; D015496:CD4-Positive T-Lymphocytes; D004168:Diphtheria Toxoid / Q000276:immunology*; D015658:HIV Infections / Q000276:immunology*; D006192:Haemophilus Infections / Q000517:prevention & control; D018073:Haemophilus Vaccines; D006193:Haemophilus influenzae / Q000276:immunology*; D006801:Humans; D007114:Immunization; D007958:Leukocyte Count; D008297:Male; D011897:Random Allocation
D016915:AIDS Vaccines; D000907:Antibodies, Bacterial; D001428:Bacterial Vaccines; D004168:Diphtheria Toxoid; D018073:Haemophilus Vaccines; C052180:Haemophilus influenzae type b-polysaccharide vaccine-diphtheria toxoid conjugate