Serological response to 13-valent pneumococcal conjugate vaccine in children and adolescents with perinatally acquired HIV infection
Serological response to 13-valent pneumococcal conjugate vaccine in children and adolescents with perinatally acquired HIV infection
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DOI：
10.1097/qad.0000000000000385
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发表时间：
2014-09-01
期刊：
影响因子：
3.8
通讯作者：
Kampmann, Beate
中科院分区：
文献类型：
--
作者：
Bamford, Alasdair;Kelleher, Peter;Kampmann, Beate
背景资料：尽管接受了高效抗逆转录病毒治疗（HAART），但患有围产期获得性HIV（paHIV）的儿童仍面临肺炎球菌感染的风险增加。婴儿期以后，对肺炎球菌结合疫苗（PCV）的反应仍然研究不足。目前还没有发表的数据对13价PCV（PCV 13）在HIV感染population.Methods的血清学反应：我们测量了肺炎球菌A型特异性IgG在48例PAHIV感染的儿童患者（CP），27名年轻成人健康对照（AHC）和30名儿童健康对照（CHC）。在一个儿童亚组中测量了三种PCV 13排他性血清型的调理吞噬试验（OPA）滴度。在CP和AHC组的PCV 13疫苗接种后1个月和6个月重复血清型特异性IgG。OPA滴度为四个血清型进行了测量，在1个月的时间点。结果：大多数CP，CHC和AHC有超过0.35 μ g/ml的基线，虽然OPA活性是不可检测的三个血清型研究的两个。对于一部分血清型，CP的基线IgG浓度显著低于AHC，并且强烈预测对疫苗的应答。调整基线后，接种后IgG浓度相当，虽然对某些血清型的反应受损的CP。OPA与免疫后IgG相关性良好。可检测的HIV病毒载量与显著较低的IgG浓度和OPA滴度相关。结论：大多数但不是所有疫苗血清型的儿童paHIV感染者对PCV 13有强烈的血清学反应。HAART的病毒载量抑制和较高的基线IgG浓度与较高的疫苗接种后抗体水平相关。这对HAART治疗和疫苗接种实践有影响。(C)2014威科健康垂直酒吧Lippincott威廉姆斯& Wilkins
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 underinvestigated. 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 mu g/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.Conclusion: 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. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins