title: Whole-cell pertussis vaccine induces low antibody levels in human immunodeficiency virus-infected children living in sub-Saharan Africa.
abstract: The WHO recommendations for the immunization of children infected with human immunodeficiency virus (HIV) differ slightly from the guidelines for uninfected children. The introduction of antiretroviral therapy for HIV-infected infants should considerably prolong their life expectancy. The question of the response to the whole-cell pertussis (wP) vaccine should now be addressed, particularly in countries in which pertussis remains endemic. To evaluate the persistence of antibodies to the wP vaccine in HIV-infected and uninfected children who had previously received this vaccine in routine clinical practice, we conducted a cross-sectional study of children aged 18 to 36 months, born to HIV-infected mothers and living in Cameroon or the Central African Republic. We tested blood samples for antibodies to the wP vaccine and for antibodies to diphtheria and tetanus toxoids (D and T, respectively) in the context of the use of a combined DTwP vaccine. We enrolled 50 HIV-infected children and 78 uninfected, HIV-exposed children in the study. A lower proportion of HIV-infected children than uninfected children had antibodies against the antigens tested for all valences of the DTwP vaccine. Agglutinin levels were substantially lower in HIV-infected than in HIV-exposed but uninfected children (30.0% versus 55.1%, respectively; P = 0.005). We also observed a high risk of low antibody levels in response to the DTwP vaccine in HIV-infected children with severe immunodeficiency (CD4 T-cell level, <25%). The concentrations of antibodies induced by the DTwP vaccine were lower in HIV-infected children than in uninfected children. This study supports the need for a booster dose of the DTwP vaccine in order to maintain high antibody levels in HIV-infected children.
authors.affiliation: Laboratoire d'Epidémiologie et de Santé Publique, Douala, Cameroon.
authors.forename: Mathurin C
authors.initials: MC
authors.lastname: Tejiokem
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Njamkepo
authors.forename: Ionela
authors.initials: I
authors.lastname: Gouandjika
authors.forename: Dominique
authors.initials: D
authors.lastname: Rousset
authors.forename: Lydie
authors.initials: L
authors.lastname: Béniguel
authors.forename: Catherine
authors.initials: C
authors.lastname: Bilong
authors.forename: Gilbert
authors.initials: G
authors.lastname: Tene
authors.forename: Ida
authors.initials: I
authors.lastname: Penda
authors.forename: Carine
authors.initials: C
authors.lastname: Ngongueu
authors.forename: Jean C
authors.initials: JC
authors.lastname: Gody
authors.forename: Nicole
authors.initials: N
authors.lastname: Guiso
authors.forename: Laurence
authors.initials: L
authors.lastname: Baril
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood*; D002163:Cameroon; D002488:Central African Republic; D002675:Child, Preschool; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000276:immunology*; D015658:HIV Infections / Q000276:immunology*; D006801:Humans; D007223:Infant
chemical_list: D000907:Antibodies, Bacterial; D015721:Diphtheria-Tetanus-Pertussis Vaccine