Omphile E Simani1, Alane Izu, Avy Violari, Mark F Cotton, Nadia van Niekerk, Peter V Adrian, Shabir A Madhi. 1. aDepartment of Science and Technology/National Research Foundation: Vaccine Preventable Diseases; Johannesburg bMedical Research Council, Respiratory and Meningeal Pathogens Research Unit, Faculty Health Sciences; University of the Witwatersrand, Faculty of Health Sciences, Johannesburg; cPerinatal HIV Research Unit, University of the Witwatersrand, Faculty of Health Sciences dStellenbosch University, Children's Infectious Diseases Clinical Research Unit, Tygerberg eDivision of National Health Laboratory Service, National Institute for Communicable Diseases, Centre for Vaccines and Immunology, Sandringham, South Africa.
Abstract
INTRODUCTION: We studied the effect of maternal HIV-exposure and timing of antiretroviral treatment (ART) in HIV-infected infants on antibody responses to combineddiphtheria-toxoid-tetanus-toxoid-whole cell pertussis and Haemophilus influenzae type b conjugate vaccine (HibCV) and monovalent hepatitis B vaccine (HBV). METHODS:HIV-uninfected infants born to HIV-infected (HEU) or HIV-uninfected (HUU) mothers were enrolled in parallel with HIV-infected children with CD4⁺ ≥25%, who were randomized to initiate ART immediately upon confirmation of HIV-infection (ART-Immed) or when clinically and/or immunologically indicated (ART-Def). Infants received three doses of diphtheria-toxoid-tetanus-toxoid -wP-HibC/HBV at 7.3, 11.4 and 15.4 weeks of age. Antibody to diphtheria-toxoid, tetanus-toxoid, pertussis toxin, filamentous hemagglutinin (FHA) and hepatitis B surface antigen (HBsAg) were measured by Luminex multiplex-immunoassay and polyribosyl-ribitol phosphate (PRP) antibodies by standard ELISA and bactericidal assay. RESULTS:Prevaccination antibody geometric mean concentrations (GMCs) were higher in HUU than HEU infants for tetanus-toxoid, but lower for HBsAg, diphtheria-toxoid and FHA. Postvaccination GMCs and proportion with seroprotective antibody levels or sero-conversion rates were similar between HUU and HEU infants for all vaccines. Postvaccination GMCs were higher in HUU for tetanus-toxoid, diphtheria-toxoid, HBsAg and FHA than ART-Immed infants; and for tetanus-toxoid, HBsAg and pertussis-toxoid than ART-Def infants. Nevertheless, there was no difference in proportion of HUU and HIV-infected infants who developed sero-protective vaccine-specific antibody levels postvaccination. The timing of ART initiation generally did not affect immune responses to vaccines between HIV-infected groups. CONCLUSION: Vaccination with DTwP-HibCV/HBV of HEU and HIV-infected infants initiated on early-ART confers similar immunity compared with HUU children.
RCT Entities:
INTRODUCTION: We studied the effect of maternal HIV-exposure and timing of antiretroviral treatment (ART) in HIV-infectedinfants on antibody responses to combined diphtheria-toxoid-tetanus-toxoid-whole cell pertussis and Haemophilus influenzae type b conjugate vaccine (HibCV) and monovalent hepatitis B vaccine (HBV). METHODS:HIV-uninfected infants born to HIV-infected (HEU) or HIV-uninfected (HUU) mothers were enrolled in parallel with HIV-infectedchildren with CD4⁺ ≥25%, who were randomized to initiate ART immediately upon confirmation of HIV-infection (ART-Immed) or when clinically and/or immunologically indicated (ART-Def). Infants received three doses of diphtheria-toxoid-tetanus-toxoid -wP-HibC/HBV at 7.3, 11.4 and 15.4 weeks of age. Antibody to diphtheria-toxoid, tetanus-toxoid, pertussis toxin, filamentous hemagglutinin (FHA) and hepatitis B surface antigen (HBsAg) were measured by Luminex multiplex-immunoassay and polyribosyl-ribitol phosphate (PRP) antibodies by standard ELISA and bactericidal assay. RESULTS: Prevaccination antibody geometric mean concentrations (GMCs) were higher in HUU than HEU infants for tetanus-toxoid, but lower for HBsAg, diphtheria-toxoid and FHA. Postvaccination GMCs and proportion with seroprotective antibody levels or sero-conversion rates were similar between HUU and HEU infants for all vaccines. Postvaccination GMCs were higher in HUU for tetanus-toxoid, diphtheria-toxoid, HBsAg and FHA than ART-Immed infants; and for tetanus-toxoid, HBsAg and pertussis-toxoid than ART-Definfants. Nevertheless, there was no difference in proportion of HUU and HIV-infectedinfants who developed sero-protective vaccine-specific antibody levels postvaccination. The timing of ART initiation generally did not affect immune responses to vaccines between HIV-infected groups. CONCLUSION: Vaccination with DTwP-HibCV/HBV of HEU and HIV-infectedinfants initiated on early-ART confers similar immunity compared with HUU children.
Authors: George K Siberry; Kunjal Patel; William J Bellini; Brad Karalius; Murli U Purswani; Sandra K Burchett; William A Meyer; Sun Bae Sowers; Angela Ellis; Russell B Van Dyke Journal: Clin Infect Dis Date: 2015-06-09 Impact factor: 9.079
Authors: Regina C M Succi; Margot R Krauss; D Robert Harris; Daisy M Machado; Maria I de Moraes-Pinto; Marisa M Mussi-Pinhata; Noris Pavia Ruz; Russell B Pierre; Lenka A Kolevic Roca; Esaú Joao; Irene Foradori; Marcelo C Scotta; Rohan Hazra; George K Siberry Journal: Pediatr Infect Dis J Date: 2018-04 Impact factor: 2.129
Authors: Catherine G Sutcliffe; Kelly Searle; Hellen K Matakala; Michelle P Greenman; Kaitlin Rainwater-Lovett; Philip E Thuma; William J Moss Journal: Pediatr Infect Dis J Date: 2017-03 Impact factor: 2.129
Authors: Eleonora A M L Mutsaerts; Marta C Nunes; Martijn N van Rijswijk; Kerstin Klipstein-Grobusch; Kennedy Otwombe; Mark F Cotton; Avy Violari; Shabir A Madhi Journal: Clin Infect Dis Date: 2019-08-01 Impact factor: 9.079
Authors: Myron J Levin; Jane C Lindsey; Susan S Kaplan; Werner Schimana; Jody Lawrence; Monica M McNeal; Mutsa Bwakura-Dangarembizi; Anthony Ogwu; Evans M Mpabalwani; Paul Sato; George Siberry; Margaret Nelson; Darcy Hille; Geoffrey A Weinberg; Adriana Weinberg Journal: AIDS Date: 2017-01-02 Impact factor: 4.177