title: Impact of enterovirus and other enteric pathogens on oral polio and rotavirus vaccine performance in Bangladeshi infants.
abstract: Oral polio vaccine (OPV) and rotavirus vaccine (RV) exhibit poorer performance in low-income settings compared to high-income settings. Prior studies have suggested an inhibitory effect of concurrent non-polio enterovirus (NPEV) infection, but the impact of other enteric infections has not been comprehensively evaluated.
  
  
  
  In urban Bangladesh, we tested stools for a broad range of enteric viruses, bacteria, parasites, and fungi by quantitative PCR from infants at weeks 6 and 10 of life, coincident with the first OPV and RV administration respectively, and examined the association between enteropathogen quantity and subsequent OPV serum neutralizing titers, serum rotavirus IgA, and rotavirus diarrhea.
  
  
  
  Campylobacter and enterovirus (EV) quantity at the time of administration of the first dose of OPV was associated with lower OPV1-2 serum neutralizing titers, while enterovirus quantity was also associated with diminished rotavirus IgA (-0.08 change in log titer per tenfold increase in quantity; P=0.037), failure to seroconvert (OR 0.78, 95% CI: 0.64-0.96; P=0.022), and breakthrough rotavirus diarrhea (OR 1.34, 95% CI: 1.05-1.71; P=0.020) after adjusting for potential confounders. These associations were not observed for Sabin strain poliovirus quantity.
  
  
  
  In this broad survey of enteropathogens and oral vaccine performance we find a particular association between EV carriage, particularly NPEV, and OPV immunogenicity and RV protection. Strategies to reduce EV infections may improve oral vaccine responses. ClinicalTrials.gov Identifier: NCT01375647.
authors.affiliation: Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville 22908, USA. Electronic address: mt2f@virginia.edu.
authors.forename: Mami
authors.initials: M
authors.lastname: Taniuchi
authors.affiliation: Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville 22908, USA.
authors.forename: James A
authors.initials: JA
authors.lastname: Platts-Mills
authors.affiliation: Center for Vaccine Science and Parasitology Lab, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka 1212, Bangladesh.
authors.forename: Sharmin
authors.initials: S
authors.lastname: Begum
authors.affiliation: Center for Vaccine Science and Parasitology Lab, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka 1212, Bangladesh.
authors.forename: Md Jashim
authors.initials: MJ
authors.lastname: Uddin
authors.affiliation: Center for Vaccine Science and Parasitology Lab, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka 1212, Bangladesh.
authors.forename: Shihab U
authors.initials: SU
authors.lastname: Sobuz
authors.affiliation: Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville 22908, USA.
authors.forename: Jie
authors.initials: J
authors.lastname: Liu
authors.affiliation: Vaccine Testing Center and Unit of Infectious Diseases, Department of Medicine, University of Vermont College of Medicine, Burlington, VT 05405, USA.
authors.forename: Beth D
authors.initials: BD
authors.lastname: Kirkpatrick
authors.affiliation: Vaccine Testing Center and Unit of Infectious Diseases, Department of Medicine, University of Vermont College of Medicine, Burlington, VT 05405, USA.
authors.forename: E Ross
authors.initials: ER
authors.lastname: Colgate
authors.affiliation: Vaccine Testing Center and Unit of Infectious Diseases, Department of Medicine, University of Vermont College of Medicine, Burlington, VT 05405, USA.
authors.forename: Marya P
authors.initials: MP
authors.lastname: Carmolli
authors.affiliation: Vaccine Testing Center and Unit of Infectious Diseases, Department of Medicine, University of Vermont College of Medicine, Burlington, VT 05405, USA.
authors.forename: Dorothy M
authors.initials: DM
authors.lastname: Dickson
authors.affiliation: Center for Public Health Genomics, University of Virginia, Charlottesville 22908, USA.
authors.forename: Uma
authors.initials: U
authors.lastname: Nayak
authors.affiliation: Center for Vaccine Science and Parasitology Lab, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka 1212, Bangladesh.
authors.forename: Rashidul
authors.initials: R
authors.lastname: Haque
authors.affiliation: Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville 22908, USA.
authors.forename: William A
authors.initials: WA
authors.lastname: Petri
authors.affiliation: Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville 22908, USA.
authors.forename: Eric R
authors.initials: ER
authors.lastname: Houpt
mesh_terms: D057134:Antibodies, Neutralizing / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D001459:Bangladesh; D002167:Campylobacter; D002169:Campylobacter Infections / Q000276:immunology*; D002675:Child, Preschool; D004770:Enterovirus; D004769:Enterovirus Infections / Q000276:immunology*; D005243:Feces; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007223:Infant; D008297:Male; D011055:Poliovirus Vaccine, Oral / Q000627:therapeutic use*; D022243:Rotavirus Vaccines / Q000627:therapeutic use*; D014613:Vaccines, Attenuated / Q000627:therapeutic use
chemical_list: D057134:Antibodies, Neutralizing; D000914:Antibodies, Viral; D007070:Immunoglobulin A; D011055:Poliovirus Vaccine, Oral; C492457:RIX4414 vaccine; D022243:Rotavirus Vaccines; D014613:Vaccines, Attenuated
keywords: Enteric infections; Oral polio vaccine; PCR; Rotavirus vaccine; Vaccine efficacy; Vaccine immunogenicity