Safety and immunogenicity of bacille Calmette-Guérin, diphtheria-tetanus-pertussis, and oral polio vaccines in newborn children in Zaire infected with human immunodeficiency virus type 1.
OBJECTIVE
To determine the safety and immunogenicity of childhood vaccines in children with perinatally acquired human immunodeficiency virus type 1 (HIV-1) infection.


METHODS
Nonrandomized, prospective cohort study; 12-month follow-up period.


METHODS
Obstetric wards and outpatient pediatric clinics at two large hospitals in Kinshasa, Zaire.


METHODS
A total of 8108 pregnant women were screened for HIV-1 antibodies. The 474 children born to 466 seropositive women identified during screening and the 616 children born to 606 seronegative, age- and parity-matched women were vaccinated.


METHODS
The following vaccines were administered at the stated ages: bacille Calmette-Guérin (BCG) vaccine (2 days); trivalent oral Sabin poliomyelitis vaccine (2 days and 6, 10, and 14 weeks); and adsorbed diphtheria-tetanus-pertussis (DTP) vaccine (6, 10, and 14 weeks).


RESULTS
Protective antibody titers to tetanus and poliovirus types 1, 2, and 3 were achieved in 95% of all children. Among children with HIV-1 infection, 70.8% had protective antibody titers to diphtheria compared with 98.5% of uninfected children (p < 0.05). Geometric mean antibody titers to diphtheria and poliovirus types 1, 2, and 3 were significantly lower in children with HIV-1 infection than in uninfected children. Vaccine-associated side effects were similarly low in all children.


CONCLUSIONS
The low incidence of side effects and the high proportion of children with HIV-1 infection who achieved protective postimmunization antibody titers support the continuing use of BCG, DTP, and oral polio vaccines in childhood immunization programs in HIV-1 endemic areas.
Department of Public Health, Mama Yemo Hospital, Kinshasa, Zaire.
R W
RW
Ryder
M J
MJ
Oxtoby
M
M
Mvula
V
V
Batter
E
E
Baende
W
W
Nsa
F
F
Davachi
S
S
Hassig
I
I
Onorato
A
A
Deforest
D000907:Antibodies, Bacterial / Q000096:biosynthesis / Q000097:blood; D000914:Antibodies, Viral / Q000096:biosynthesis / Q000097:blood; D001500:BCG Vaccine / Q000009:adverse effects / Q000276:immunology*; D016022:Case-Control Studies; D015023:Democratic Republic of the Congo; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000009:adverse effects / Q000276:immunology*; D005260:Female; D015658:HIV Infections / Q000276:immunology* / Q000635:transmission; D006679:HIV Seropositivity; D015497:HIV-1 / Q000276:immunology; D006801:Humans; D007231:Infant, Newborn; D009035:Mothers; D011055:Poliovirus Vaccine, Oral / Q000276:immunology*; D011247:Pregnancy; D011446:Prospective Studies
D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D001500:BCG Vaccine; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D011055:Poliovirus Vaccine, Oral