The immunogenicity of Haemophilus influenzae type b conjugate vaccines in children born to human immunodeficiency virus-infected women. Women and Infants Transmission Study Group.
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 approximately 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 microg/ml) than among uninfected children (2.70 microg/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 > or = 0.48). The proportion of children with antibody concentrations > or = 1.0 microg/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.
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Pediatric, Adolescent, and Maternal AIDS Branch, National Institute of Child Health and Human Development, Bethesda, MD 20892-7510, USA. jr92o@nih.gov
Frasch
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Rich
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Fitzgerald
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Clemens
J D
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Pitt
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Pelton
S I
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Hanson
I C
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Handelsman
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Diaz
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Fowler
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D000907:Antibodies, Bacterial / Q000302:isolation & purification*; D000942:Antigens, Bacterial / Q000276:immunology; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections; D018023:HIV Seronegativity; D006679:HIV Seropositivity; D018073:Haemophilus Vaccines / Q000008:administration & dosage / Q000276:immunology*; D006193:Haemophilus influenzae / Q000276:immunology*; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D010428:Pentosephosphates / Q000276:immunology; D011135:Polysaccharides, Bacterial / Q000276:immunology; D018074:Vaccines, Conjugate / Q000008:administration & dosage / Q000276:immunology; D019562:Viral Load
D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D018073:Haemophilus Vaccines; D010428:Pentosephosphates; D011135:Polysaccharides, Bacterial; D018074:Vaccines, Conjugate; C003191:polyribose phosphate