title: Immunologic response to oral polio vaccine in human immunodeficiency virus-infected and uninfected Zimbabwean children.
abstract: BACKGROUND
  Poliovirus eradication is dependent on maintaining adequate community-wide levels of serologic protection. Many African countries with conditions that favor continued wild poliovirus propagation also have a high prevalence of pediatric human immunodeficiency virus (HIV) infection. Data are limited regarding the degree of serologic immunity conferred on HIV-infected children after immunization with oral polio vaccine (OPV).
  
  
  METHODS
  This was a cross-sectional study correlating HIV infection and neutralizing antibodies against poliovirus serotypes 1, 2, and 3 in 95 Zimbabwean children 2 months to 2 years of age, born to HIV-infected mothers, who received OPV according to the national schedule.
  
  
  RESULTS
  HIV-infected children had significantly lower rates of seroconversion to all 3 poliovirus serotypes than HIV-uninfected children (60%, 67%, and 47% vs. 96%, 100%, and 82%, P = 0.001, 0.0003, and 0.015 for serotypes 1, 2, and 3 in HIV-infected and uninfected children, respectively, after ≥3 OPV doses). Among poliovirus seroconverters, HIV-infected children also had significantly lower geometric mean titers against serotypes 1 and 2 than HIV-uninfected children (geometric mean titers: 198 and 317 vs. 1193 and 1056, P = 0.032 and 0.050, for serotypes 1 and 2, respectively, after ≥3 OPV doses). In addition, HIV-infected children had significantly higher levels of total IgG and significantly lower CD4% and mean weight than HIV-uninfected children. Of note, none of the HIV-infected children were receiving antiretroviral therapy, and 71% had a CD4% indicating severe immunodeficiency.
  
  
  CONCLUSIONS
  Pediatric HIV infection is associated with a poor serologic response to OPV, which could pose an obstacle to global polio eradication.
authors.affiliation: Division of Pediatric Infectious Diseases, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Devasena
authors.initials: D
authors.lastname: Gnanashanmugam
authors.forename: Stephanie B
authors.initials: SB
authors.lastname: Troy
authors.forename: Georgina
authors.initials: G
authors.lastname: Musingwini
authors.forename: Chunhong
authors.initials: C
authors.lastname: Huang
authors.forename: Meira S
authors.initials: MS
authors.lastname: Halpern
authors.forename: Lynda
authors.initials: L
authors.lastname: Stranix-Chibanda
authors.forename: Avinash K
authors.initials: AK
authors.lastname: Shetty
authors.forename: Diana
authors.initials: D
authors.lastname: Kouiavskaia
authors.forename: Kusum
authors.initials: K
authors.lastname: Nathoo
authors.forename: Konstantin
authors.initials: K
authors.lastname: Chumakov
authors.forename: Yvonne A
authors.initials: YA
authors.lastname: Maldonado
mesh_terms: D057134:Antibodies, Neutralizing / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D018791:CD4 Lymphocyte Count; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D008297:Male; D011051:Poliomyelitis / Q000517:prevention & control*; D011055:Poliovirus Vaccine, Oral / Q000008:administration & dosage / Q000276:immunology*; D015030:Zimbabwe
chemical_list: D057134:Antibodies, Neutralizing; D000914:Antibodies, Viral; D007074:Immunoglobulin G; D011055:Poliovirus Vaccine, Oral