Journal
VACCINE
Volume 31, Issue 5, Pages 777-783Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.vaccine.2012.11.076
Keywords
Streptococcus pneumoniae; Pneumococcal conjugate vaccine; Dosing schedules; HIV; Opsonophagocytic assay
Categories
Funding
- National Institute of Allergy and Infectious Diseases (NIAID) of the US National Institutes for Health (NIH), through the Comprehensive International Program of Research on AIDS (CIPRA) network [U19 AI53217]
- National Institute of Allergies & Infectious Diseases, National Institutes of Health, Department of Health and Human Services [HHSN272200800014C]
- Bill and Melinda Gates Foundation: Grand Challenges Program [37875]
- Pfizer
- GSK
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Background: The immunogenicity of pneumococcal conjugate vaccine (PCV) has not been evaluated in HIV-infected infants following the first and second PCV-doses. We studied antibody kinetics of serotypes included in 7-valent PCV in HIV-infected and HIV-uninfected infants prior to and following each of three PCV-doses. Methods: HIV-uninfected infants born to HIV-uninfected (HUU) and HIV-infected mothers (HEU); and perinatal HIV-infected children with CD4+ <25% randomized to initiate antiretroviral treatment (ART) when clinically and/or immunologically indicated (ART-) or immediately (ART+) were enrolled. Vaccination occurred at approximately 7.4, 11.5 and 15.5 weeks of age. Serotype-specific antibody was measured by ELISA following each PCV-dose and opsonophagocytic activity (OPA) to three serotypes following the second and third doses. Results: Pre-vaccination, antibody geometric mean concentrations (GMCs) were higher in HUU compared to HIV-exposed groups for most serotypes. GMCs and proportion of infants with antibody >= 0.35 mu g/ml were similar in HUU compared to other groups following the second PCV-dose. In all groups, GMCs were greater following the third compared to post-second dose; and a higher proportion within each group had antibody >= 0.35 mu g/ml to 6B and 23F. OPA GMTs increased after the third compared to post-second dose for studied-serotypes; as did the proportion with OPA >= 8 to 23F. Conclusion: A two-dose primary-series of PCV probably confers similar protection against invasive pneumococcal disease in HIV-infected compared to HUU children. The inferior response to serotypes 6B and 23F, and lower GMCs and OPA GMTs, following two compared to after three PCV-doses may have implications in the prevention of pneumococcal disease in high-burden countries. (C) 2012 Elsevier Ltd. All rights reserved.
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