[Persistence of hepatitis A virus antibodies after primary immunization and response to revaccination in children and adolescents with perinatal HIV exposure].
OBJECTIVE
To assess possible factors associated with the loss of antibodies to hepatitis A 7 years after the primary immunization in children of HIV-infected mothers and the response to revaccination in patients seronegative for hepatitis A.


METHODS
Quantification of HAV antibodies by electrochemiluminescence was performed in 39 adolescents followed up at the Pediatric Aids Clinic of Federal University of São Paulo (Unifesp): 29 HIV-infected (HIVgroup) (median age: 12.8 years) and 10 HIV-exposed but non-infected (ENI group) (median age: 13.4 years). All of them received two doses of HAV vaccine (Havrix(®)) in 2002.


RESULTS
The median age at primary immunization (PI) was 5.4 years for HIV group and 6.5 years for ENI group. All children, from both groups, had antibodies to HAV >20 mIU/mL after PI. Seven years later, the ENI group showed a median concentration of antibodies = 253.5 mIU/mL, while the HIV group = 113.0 mIU/mL (Mann-Whitney test, p=0.085). All ENI group and 23/29 (79.3%) from HIV group mantained HAV antibodies 7 years after PI. The levels of hepatitis A antibodies in the primary vaccination were the only factor independently associated with maintaining these antibodies for 7 years. The group that lost HAV seropositivity was revaccinated and 83.3% (5/6) responded with antibodies >20 mUI/mL.


CONCLUSIONS
The antibodies levels acquired in the primary vaccination in the HIV group were the main factor associated with antibodies loss after HAV immunization.
Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM/Unifesp), São Paulo, SP, Brasil. Electronic address: aidagouvea@uol.com.br.
Aída de Fátima Thomé Barbosa
Ade F
Gouvêa
Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM/Unifesp), São Paulo, SP, Brasil.
Maria Isabel de Moraes
MI
Pinto
Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM/Unifesp), São Paulo, SP, Brasil.
Maristela
M
Miyamoto
Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM/Unifesp), São Paulo, SP, Brasil.
Daisy Maria
DM
Machado
Ambulatório de Infectologia Pediátrica do Centro de Referência de DST/Aids (CR DST/Aids) do Município de Diadema e do Serviço de Atendimento Especializado (SAE), Diadema, SP, Brasil.
Silvana Duarte
SD
Pessoa
Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM/Unifesp), São Paulo, SP, Brasil.
Fabiana Bononi do
FB
Carmo
Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM/Unifesp), São Paulo, SP, Brasil.
Suênia Cordeiro de Vasconcelos
SC
Beltrão
Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM/Unifesp), São Paulo, SP, Brasil.
Regina Célia de Menezes
RC
Succi
D000293:Adolescent; D002648:Child; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000635:transmission; D035922:Hepatitis A Antibodies / Q000097:blood*; D022362:Hepatitis A Vaccines; D006801:Humans; D007117:Immunization, Secondary; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D011446:Prospective Studies
D035922:Hepatitis A Antibodies; D022362:Hepatitis A Vaccines
Adolescent and children; Crianças e adolescentes; HIV; Hepatitis A vaccine; Immunossupression; Imunossupressão; Vacina de hepatite A