Immunogenicity and effectiveness of Haemophilus influenzae type b conjugate vaccine in HIV infected and uninfected African children.
The quantitative (anti-Hib capsular polysaccharide antibody concentrations; anti-HibPS) and qualitative (bactericidal activity and avidity) aspects in immune responses to Haemophilus influenzae type b polyribosyl ribitol phospshate-CRM(197) conjugate vaccine (HibCV; HibTiter) were evaluated in 66 HIV infected children not receiving anti-retroviral therapy and 127 HIV uninfected children. Surveillance was conducted for invasive Hib disease in a cohort of 39,865 (approximately 6.4% of whom were HIV infected) children from March 1998 to June 2004. HIV infected children had lower anti-HibPS geometric mean antibody concentrations 1 month post-immunisation than HIV uninfected children (P<0.00001) and were less likely to have anti-HibPS antibody concentrations of >or=1.0 microg/ml (RR 0.54; 95% CI 0.43-0.69). A lower proportion of HIV infected children than HIV uninfected children (RR 0.78; 95% CI 0.66-0.93) had measurable anti-Hib serum bactericidal activity (SBA) and the HibPS antibody concentration required for 50% killing of Hib bacteria was greater among HIV infected than HIV uninfected children (P=0.001). The estimated risk of HibCV failure was 35.1-fold greater (95% CI 14.6-84.6) amongst HIV infected than HIV uninfected children.
Madhi
Shabir A
SA
University of the Witwatersrand, Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, South Africa. madhis@hivsa.com
Kuwanda
Locadiah
L
Saarinen
Leena
L
Cutland
Clare
C
Mothupi
Rosalia
R
Käyhty
Helena
H
Klugman
Keith P
KP
D000349:Africa; D000907:Antibodies, Bacterial / Q000097:blood; D017326:Clinical Trials, Phase III as Topic; D015658:HIV Infections / Q000276:immunology*; D015497:HIV-1; D006192:Haemophilus Infections / Q000453:epidemiology / Q000517:prevention & control*; D018073:Haemophilus Vaccines / Q000008:administration & dosage* / Q000276:immunology; D019741:Haemophilus influenzae type b / Q000276:immunology*; D006801:Humans; D007109:Immunity / Q000187:drug effects; D007223:Infant; D007231:Infant, Newborn; D018074:Vaccines, Conjugate / Q000008:administration & dosage* / Q000276:immunology
D000907:Antibodies, Bacterial; D018073:Haemophilus Vaccines; D018074:Vaccines, Conjugate