Document Detail


Reduced Poliovirus vaccine neutralising-antibody titres in infants with maternal HIV-exposure.
MedLine Citation:
PMID:  23474309     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Maternally HIV-exposed (mHIV-EU) infants have poor health even without HIV-1 infection. The responses to vaccination are less well defined. Immunity to oral Poliovirus vaccine (OPV) was studied in Zambian infants participating in a randomised controlled trial of micronutrient fortification to improve child health.
METHOD: Maternally HIV-unexposed and mHIV-EU infants were recruited at 6 months age and randomised to basal or enriched micronutrient-fortified diets for 12 months. HIV-exposed mother-infant pairs had received perinatal nevirapine to prevent mother-to-child-transmission. In the cohort of 597 infants, neutralising-antibody titres to OPV were analysed at 18 months with respect to micronutrient fortification, maternal or infant HIV-1 infection, and human cytomegalovirus (HCMV) infection detected by antibodies and viraemia (serum DNA). Vaccine protection was defined as log2 titre>3.
RESULTS: Compared to uninfected children, HIV-1-infected children had reduced neutralising antibody titres to OPV, irrespective of diet: log2 titre difference (95% confidence interval) -3.44 (-2.41; -4.46), P<0.01. OPV antibody titres were lower in HIV-infected children with HCMV viraemia compared to those without viraemia at 18 months, but did not reach significance: difference -2.55 (-6.10; 1.01), P=0.14. Breast-feeding duration was independently associated with increasing OPV titre (P-value<0.01). In mHIV-EU children there were reduced neutralising antibody titres to Poliovirus compared with maternally HIV-unexposed, irrespective of diet, maternal education and socioeconomic status: log2 titre difference (95% confidence interval) -0.56 (-0.98; -0.15), P<0.01. This difference was noticeably decreased after adjusting for breast-feeding duration, suggesting that in our study population less breast-feeding by HIV-positive mothers could explain the reduced OPV titres in mHIV-EU infants.
CONCLUSION: The mHIV-EU infants had reduced polio vaccine antibody titres which were associated with reduced breast-feeding duration. This has important implications for polio eradication and control of vaccine-preventable diseases, in countries where childhood HIV-1 infection and maternal exposure are public health threats.
Authors:
Marta Sanz-Ramos; Daniela Manno; Mirriam Kapambwe; Ida Ndumba; Kunda G Musonda; Matthew Bates; Julia Chibumbya; Joshua Siame; Mwaka Monze; Suzanne Filteau; Ursula A Gompels;
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2013-03-06
Journal Detail:
Title:  Vaccine     Volume:  31     ISSN:  1873-2518     ISO Abbreviation:  Vaccine     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-25     Completed Date:  2014-02-06     Revised Date:  2014-05-07    
Medline Journal Info:
Nlm Unique ID:  8406899     Medline TA:  Vaccine     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  2042-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2013. Published by Elsevier Ltd.
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MeSH Terms
Descriptor/Qualifier:
Antibodies, Neutralizing / blood*,  immunology
Antibodies, Viral / blood,  immunology*
Breast Feeding
Cytomegalovirus Infections / diagnosis
Female
HIV Infections / immunology,  transmission*
HIV Seropositivity / blood,  immunology*
Humans
Infant
Infectious Disease Transmission, Vertical*
Poliomyelitis / immunology,  prevention & control
Poliovirus / immunology*
Poliovirus Vaccines / immunology*
Vaccination
Chemical
Reg. No./Substance:
0/Antibodies, Neutralizing; 0/Antibodies, Viral; 0/Poliovirus Vaccines
Investigator
Investigator/Affiliation:
Suzanne Filteau / ; Lackson Kasonka / ; Rosalind Gibson / ; Ursula A Gompels / ; Shabbar Jaffar / ; Emmanuel Kafwembe / ; Mwaka Monze / ; Moses Sinkala / ; Andrew Tomkins / ; Rodah Zulu / ; Molly Chisenga / ; Joshua Siame / ; Hildah Banda Mabuda / ; Kathy Baisley / ; Helen Dale / ; Natasha Larke / ; Daniela Manno / ; Andrea Rehman / ; Matthew Bates / ; Anne Mullen / ; Kunda Musonda / ; Marta Sanz-Ramos / ; Hellen Kangwa Bwalya / ; Margaret Chileshe / ; Priscilla Kangwa Kowa / ; Mabvuto Kumwenda / ; Munalula Likando / ; Sydney Mambwe / ; Mutinta Muzyamba / ; Anne Mwale / ; Lungowe Nyaywa / ; Humphrey Bima / ; Julia Chibumbya / ; Laura Gosset / ; Louise Hackett / ; Abigail Jackson / ; Mirriam Kapambwe / ; Mazyanga Liewe / ; Sydney Mwanza / ; Ida Ndumba / ; Eric Njunju / ; Concillia Kabanga / ; Natalia Shampwaya / ; John Chobo / ; Winford Kapumba / ; Charity Musonda / ; Philip Soko /

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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