Immunity After Childhood Vaccinations in Perinatally HIV-exposed Children With and Without HIV Infection in Latin America

Immunity After Childhood Vaccinations in Perinatally HIV-exposed Children With and Without HIV Infection in Latin America

Author Succi, Regina Célia de Menezes Autor UNIFESP Google Scholar
Krauss, Margot R. Google Scholar
Harris, D. Robert Google Scholar
Machado, Daisy Maria Autor UNIFESP Google Scholar
Moraes-Pinto, Maria Isabel de Autor UNIFESP Google Scholar
Mussi-Pinhata, Marisa M. Google Scholar
Ruz, Noris Pavia Google Scholar
Pierre, Russell B. Google Scholar
Roca, Lenka A. Kolevic Google Scholar
Joao, Esau Google Scholar
Foradori, Irene Google Scholar
Scotta, Marcelo C. Google Scholar
Hazra, Rohan Google Scholar
Siberry, George K. Google Scholar
Abstract Background: Perinatally HIV-infected (PHIV) children are at risk for under-vaccination and poor vaccine response at 4 years of age. Childhood vaccine coverage and immune response were compared between PHIV and HIV-exposed uninfected (HEU) children in Latin America and the Caribbean. Methods: PHIV and HEU children were enrolled prospectively at 15 sites from 2002 to 2009. Full vaccination by age 4 years was defined as: 3 hepatitis B virus vaccine doses

4 tetanus toxoid-containing vaccine doses

3 doses of Haemophilus influenzae type b vaccine by age 12 months or >= 1 dose given after age 12 months

one measles-containing vaccine dose

one rubella-containing vaccine dose. Immunity was defined by serum antibody titer. Fisher exact test (for categorical measures) and t test (for continuous measures) were used for comparisons. Results: Among 519 children seen at age 4 years, 191 had serum specimens available (137 PHIV, 54 HEU). Among those with specimens available, 29.3% initiated combination antiretroviral therapy (cART) <12 months of age, 30.9% initiated at >= 12 months of age, and 39.8% had not received cART by the time they were seen at 4 years of age. At 4 years of age, 59.9% were on PI-containing cART (cART/PI), and 20.4% were on no ART. PHIV children were less likely than HEU children to be fully vaccinated for tetanus (55.5% vs. 77.8%, P = 0.005) and measles and rubella (both 70.1% vs. 94.4%, P < 0.001). Among those fully vaccinated, immunity was significantly lower among PHIV than HEU for all vaccines examined: 20.9% versus 37.8% for hepatitis B virus (P = 0.04), 72.0% versus 90.5% for tetanus (P = 0.02), 51.4% versus 68.8% for H. influenzae type b (P = 0.05), 80.2% versus 100% for measles (P < 0.001) and 72.9% versus 98.0% for rubella (P < 0.001) vaccine, respectively. Conclusions: Compared with HEU, PHIV children were significantly less likely to be immune to vaccine-preventable diseases when fully vaccinated. Strategies to increase immunity against vaccine-preventable diseases among PHIV require further study.
Keywords pediatric HIV infection
Latin America
xmlui.dri2xhtml.METS-1.0.item-coverage Philadelphia
Language English
Sponsor NICHD
Grant number NICHD: N01-HD-3-3345
NICHD: HHSN267200800001C
NICHD: HHSN275201300003C
Date 2018
Published in Pediatric Infectious Disease Journal. Philadelphia, v. 37, n. 4, p. 304-309, 2018.
ISSN 0891-3668 (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 304-309
Access rights Closed access
Type Article
Web of Science ID WOS:000431713300013

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