title: Antibody persistence and immunologic memory after sequential pneumococcal conjugate and polysaccharide vaccination in HIV-infected children on highly active antiretroviral therapy.
abstract: BACKGROUND
  The capacity of pneumococcal vaccination to confer memory in HIV-infected children is critical for durable protection.
  
  
  METHODS
  HIV-infected children 2-<19 years administered two doses of pneumococcal conjugate vaccine (PCV7) and one dose of polysaccharide vaccine (PPV) on HAART were randomized 4-5 years later to receive a PCV7 or PPV booster. Total and high avidity antibodies to serotypes 1 (PPV) and 6B and 14 (PCV7 and PPV) were determined by ELISA. Memory was defined as persistence of ≥ 0.5 mcg/mL of serotype-specific antibody on day 0 or change from <0.5 mcg/mL to ≥ 0.5 mcg/mL between day 0 and week 1, or, ≥ 4-fold antibody rise between day 0 and week 1.
  
  
  RESULTS
  Prior to boosting, 4-5 years after the previous PCV7-PCV7-PPV series, geometric mean concentrations (GMCs) were 0.46 mcg/mL (serotype 1), 1.31 mcg/mL (serotype 6B), and 1.47 mcg/mL (serotype 14), with concentrations ≥ 0.5 mcg/mL in 41% (serotype 1) to 82% (serotypes 6B and 14). Memory based on antibody concentration ≥ 0.5 mcg/mL before or 1 week after boosting with PCV7 or PPV was demonstrated in 42-61% for serotype 1 and 87-94% for serotypes 6B and 14, with lower rates based on day 0 to week 1 ≥ 4-fold antibody rise (serotype 1, 3-13%; serotype 6B, 13-31%; serotype 14, 29-53%). Antibody concentrations post-boosting were greater following PCV7 than PPV for serotypes 6B and 14. Ratios of highly avid to total antibody pre- and post-boosting were 0.5-0.8. Predictors of memory included higher CD4% (nadir before HAART and at P1024 and P1061s entry), CD19% (at P1024 and P1061s entry), and antibody response after the PCV7-PCV7-PPV primary series and lower viral load (at P1024 and P1061s entry) and age.
  
  
  CONCLUSIONS
  Protective antibody concentrations, high avidity, and booster responses to PCV7 or PPV indicative of memory were present 4-5 years after PCV7-PCV7-PPV in HIV-infected children on HAART.
authors: Department of Pediatrics (Infectious Diseases), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA. Electronic address: mark.abzug@childrenscolorado.org.
authors: Mark J
authors: MJ
authors: Abzug
authors: Lin Ye
authors: LY
authors: Song
authors: Myron J
authors: MJ
authors: Levin
authors: Sharon A
authors: SA
authors: Nachman
authors: William
authors: W
authors: Borkowsky
authors: Stephen I
authors: SI
authors: Pelton
mesh_terms: D000293:Adolescent; D000907:Antibodies, Bacterial / Q000097:blood*; D000915:Antibody Affinity; D023241:Antiretroviral Therapy, Highly Active; D002648:Child; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007156:Immunologic Memory; D008297:Male; D011008:Pneumococcal Infections / Q000276:immunology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000276:immunology*; D014611:Vaccination / Q000379:methods*; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial; D022242:Pneumococcal Vaccines
keywords: Children; HIV; Memory; PCV; PPV; Pneumococcal; VL; Vaccine; pneumococcal conjugate vaccine; pneumococcal polysaccharide vaccine; viral load
references: J Infect Dis. 2010 Aug 15;202(3):355-61
references: 20583920
references: Clin Exp Immunol. 1999 Dec;118(3):402-7
references: 10594558
references: AIDS. 2011 Feb 20;25(4):453-62
references: 21178754
references: Vaccine. 2001 Nov 12;20(3-4):545-53
references: 11672921
references: Vaccine. 2005 Nov 16;23(46-47):5289-93
references: 16054732
references: Clin Diagn Lab Immunol. 2005 Jan;12(1):165-70
references: 15643002
references: AIDS. 2003 Jun 13;17(9):1396-8
references: 12799564
references: Arch Dis Child. 2003 May;88(5):379-83
references: 12716702
references: J Infect Dis. 2009 Apr 15;199(8):1168-76
references: 19265481
references: J Infect Dis. 2012 Aug 15;206(4):512-22
references: 22693229
references: J Infect Dis. 2009 Sep 15;200(6):935-46
references: 19663708
references: Infect Immun. 1999 May;67(5):2366-70
references: 10225896
references: Arch Pediatr Adolesc Med. 1996 Aug;150(8):838-41
references: 8704891
references: Lancet Infect Dis. 2008 Jan;8(1):67-80
references: 17974480
references: Vaccine. 2011 Aug 11;29(35):5886-91
references: 21729732
references: N Engl J Med. 2010 Mar 4;362(9):812-22
references: 20200385
references: Vaccine. 2007 Mar 22;25(13):2451-7
references: 17023095
references: Ann Intern Med. 2006 Jan 3;144(1):1-9
references: 16389249
references: J Immunol. 2008 Feb 15;180(4):2165-73
references: 18250423
references: Blood. 2006 Sep 1;108(5):1580-7
references: 16645169
references: J Infect Dis. 2009 Apr 15;199(8):1109-11
references: 19265480
references: Lancet Infect Dis. 2007 Sep;7(9):597-606
references: 17714673
references: Clin Infect Dis. 2007 Jun 15;44(12):1569-76
references: 17516400
references: J Infect Dis. 2001 Nov 1;184(9):1211-5
references: 11598848
references: J Infect Dis. 2011 Aug 15;204(4):534-43
references: 21791655
references: Vaccine. 2011 Apr 18;29(18):3372-3
references: 21396901
references: AIDS. 2007 Aug 20;21(13):1747-52
references: 17690573
references: Pediatr Infect Dis J. 2006 Oct;25(10):920-9
references: 17006288
references: Pediatr Infect Dis J. 2005 May;24(5):410-6
references: 15876939
references: J Immunol. 2007 Jun 15;178(12):8212-20
references: 17548660