title: Immunogenicity and safety of meningococcal C conjugate vaccine in children and adolescents infected and uninfected with HIV in Rio de Janeiro, Brazil.
abstract: BACKGROUND
  We aimed to evaluate the Meningococcal (Neisseria meningitidis) C conjugated (MCC) vaccine seroconversion and adverse events (AEs) in HIV-infected and HIV-uninfected children and adolescents in Rio de Janeiro, Brazil.
  
  
  METHODS
  HIV-infected or HIV-uninfected subjects, 2-18 years old, with CD4+ T-lymphocyte cell (CD4) percentage >15%, without active infection or antibiotic use, were enrolled. All patients were evaluated before and 1-2 months after immunization for seroconversion (defined as ≥4-fold titer increase in human serum bactericidal activity) and at 20 minutes, 3 and 7 days after immunization for AEs. Factors associated with seroconversion among HIV-infected group were studied.
  
  
  RESULTS
  Two hundred four subjects were enrolled: 154 HIV-infected and 50 HIV-uninfected. Median age was 12 years, and 53% were female. Among the HIV-infected group, 82 (53%) had a history of at least 1 C clinical category of Centers for Diseases Control and Prevention event, and 134 (87%) were using combination antiretroviral therapy. The median nadir CD4 percentage was 13% (0-47%). Seventy-six (37.3%) experienced mild AEs. Seroconversion occurred in 46 of 154 (30%) in the HIV-infected group and in 38 of 50 (76%) in the uninfected group (P < 0.01). Factors associated with seroconversion in the HIV-infected group were as follows: never had a C clinical category event [odds ratio (OR) = 2.1, 95% confidence interval (CI): 1.0-4.4]; undetectable viral load at immunization (OR: 2.4, 95% CI: 1.1-5.2) and higher CD4 nadir/100 cells (OR: 1.1, 95% CI: 1.0-1.2).
  
  
  CONCLUSIONS
  MCC vaccine should be administered to HIV-infected children and adolescents after maximum immunologic and virologic benefits have been achieved with combination antiretroviral therapy. Our data suggest that a single dose of MCC vaccine is insufficient for HIV-infected individuals 2-18 years of age.
authors: From the *Department of Pediatrics and †Department of Preventive Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; ‡Department of Microbiology and Immunology, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil; and §Infectious Diseases Epidemiology Research Unit, University of Pittsburgh, Pittsburgh, PA.
authors: Ana Cristina C
authors: AC
authors: Frota
authors: Lucimar G
authors: LG
authors: Milagres
authors: Lee H
authors: LH
authors: Harrison
authors: Bianca
authors: B
authors: Ferreira
authors: Daniela
authors: D
authors: Menna Barreto
authors: Gisele S
authors: GS
authors: Pereira
authors: Aline C
authors: AC
authors: Cruz
authors: Wania
authors: W
authors: Pereira-Manfro
authors: Ricardo Hugo
authors: RH
authors: de Oliveira
authors: Thalita F
authors: TF
authors: Abreu
authors: Cristina B
authors: CB
authors: Hofer
mesh_terms: D000293:Adolescent; D000907:Antibodies, Bacterial / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D002648:Child; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000276:immunology*; D006801:Humans; D008297:Male; D008589:Meningococcal Infections / Q000517:prevention & control*; D022401:Meningococcal Vaccines / Q000009:adverse effects* / Q000276:immunology*; D011446:Prospective Studies
chemical_list: D000907:Antibodies, Bacterial; D022401:Meningococcal Vaccines; C410218:serogroup C meningococcal conjugate vaccine