title: Vaccine poliovirus shedding and immune response to oral polio vaccine in HIV-infected and -uninfected Zimbabwean infants.
abstract: BACKGROUND
  With prolonged replication, attenuated polioviruses used in oral polio vaccine (OPV) can mutate into vaccine-derived poliovirus (VDPV) and cause poliomyelitis outbreaks. Individuals with primary humoral immunodeficiencies can become chronically infected with vaccine poliovirus, allowing it to mutate into immunodeficiency-associated VDPV (iVDPV). It is unclear if children perinatally infected with the human immunodeficiency virus (HIV), who have humoral as well as cellular immunodeficiencies, might be sources of iVDPV.
  
  
  METHODS
  We conducted a prospective study collecting stool and blood samples at multiple time points from Zimbabwean infants receiving OPV according to the national schedule. Nucleic acid extracted from stool was analyzed by real-time polymerase chain reaction for OPV serotypes.
  
  
  RESULTS
  We analyzed 825 stool samples: 285 samples from 92 HIV-infected children and 540 from 251 HIV-uninfected children. Poliovirus shedding was similar after 0-2 OPV doses but significantly higher in the HIV-infected versus uninfected children after ≥ 3 OPV doses, particularly within 42 days of an OPV dose, independent of seroconversion status. HIV infection was not associated with prolonged or persistent poliovirus shedding. HIV infection was associated with significantly lower polio seroconversion rates.
  
  
  CONCLUSIONS
  HIV infection is associated with decreased mucosal and humoral immune responses to OPV but not the prolonged viral shedding required to form iVDPV.
authors: Department of Internal Medicine, Division of Infectious Diseases, Eastern Virginia Medical School, Norfolk, VA 23507, USA. troysb@evms.edu
authors: Stephanie B
authors: SB
authors: Troy
authors: Georgina
authors: G
authors: Musingwini
authors: Meira S
authors: MS
authors: Halpern
authors: Chunhong
authors: C
authors: Huang
authors: Lynda
authors: L
authors: Stranix-Chibanda
authors: Diana
authors: D
authors: Kouiavskaia
authors: Avinash K
authors: AK
authors: Shetty
authors: Konstantin
authors: K
authors: Chumakov
authors: Kusum
authors: K
authors: Nathoo
authors: Yvonne A
authors: YA
authors: Maldonado
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D001769:Blood / Q000276:immunology / Q000821:virology; D005243:Feces / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000276:immunology*; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D017955:Poliovirus / Q000302:isolation & purification*; D011055:Poliovirus Vaccine, Oral / Q000008:administration & dosage* / Q000276:immunology*; D011446:Prospective Studies; D012367:RNA, Viral / Q000235:genetics / Q000302:isolation & purification; D060888:Real-Time Polymerase Chain Reaction; D017201:Virus Shedding; D015030:Zimbabwe
chemical_list: D000914:Antibodies, Viral; D011055:Poliovirus Vaccine, Oral; D012367:RNA, Viral
keywords: HIV; OPV; VDPV; immunity; infants; polio; shedding; vaccine
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