title: Serological response to 13-valent pneumococcal conjugate vaccine in children and adolescents with perinatally acquired HIV infection.
abstract: BACKGROUND
  Children with perinatally acquired HIV (paHIV) remain at an increased risk of pneumococcal infection despite highly active antiretroviral therapy (HAART). Beyond infancy, responses to pneumococcal conjugate vaccine (PCV) remain under-investigated. There are currently no published data on serological response to 13-valent PCV (PCV13) in the HIV-infected populations.
  
  
  METHODS
  We measured pneumococcal serotype-specific IgG in 48 paHIV-infected child patients (CP), 27 young adult healthy controls (AHC) and 30 child healthy controls (CHC). Opsonophagocytic assay (OPA) titres for three PCV13-exclusive serotypes were measured in a subset of children. Serotype-specific IgG was repeated 1 and 6 months following PCV13 vaccination of CP and AHC groups. OPA titres for four serotypes were measured at the 1-month time-point.
  
  
  RESULTS
  The majority of CP, CHC and AHC had serotype-specific IgG above 0.35  μg/ml at baseline, although OPA activity was undetectable for two of the three serotypes studied. Baseline IgG concentrations were significantly lower in CP than AHC for a proportion of serotypes and were strongly predictive of responses to vaccine. After adjusting for baseline, postvaccination IgG concentrations were comparable, although responses to some serotypes were impaired for CP. OPA correlated well with IgG after vaccination. Detectable HIV viral load was associated with significantly lower IgG concentration and OPA titre.
  
  
  CONCLUSIONS
  Children with paHIV mount a robust serological response to PCV13 for most but not all vaccine serotypes. Viral load suppression with HAART and higher baseline IgG concentration are associated with higher postvaccination antibody levels. This has implications for HAART treatment and vaccination practices.
authors.affiliation: aSection of Paediatrics bSection of Immunology, Division of Infectious Diseases, Imperial College cDepartment of Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust dImmunobiology Section, Institute of Child Health, University College London, UK eMRC Unit, The Gambia, Vaccinology Theme, Fajara, The Gambia, West Africa.
authors.forename: Alasdair
authors.initials: A
authors.lastname: Bamford
authors.forename: Peter
authors.initials: P
authors.lastname: Kelleher
authors.forename: Hermione
authors.initials: H
authors.lastname: Lyall
authors.forename: Mitch
authors.initials: M
authors.lastname: Haston
authors.forename: Marta
authors.initials: M
authors.lastname: Zancolli
authors.forename: David
authors.initials: D
authors.lastname: Goldblatt
authors.forename: Beate
authors.initials: B
authors.lastname: Kampmann
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000276:immunology / Q000517:prevention & control*; D000293:Adolescent; D000907:Antibodies, Bacterial / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D023241:Antiretroviral Therapy, Highly Active; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood* / Q000276:immunology; D008297:Male; D011008:Pneumococcal Infections / Q000097:blood / Q000276:immunology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000276:immunology; D017410:Practice Guidelines as Topic; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom; D014611:Vaccination; D018074:Vaccines, Conjugate / Q000008:administration & dosage; D055815:Young Adult
chemical_list: C538862:13-valent pneumococcal vaccine; D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D007074:Immunoglobulin G; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate