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Frota ACC, Harrison LH, Ferreira B, Menna‐Barreto D, Castro RBND, Silva GPD, Oliveira RHD, Abreu TF, Milagres LG, Hofer CB. Antibody persistence following meningococcal C conjugate vaccination in children and adolescents infected with human immunodeficiency virus. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2017. [DOI: 10.1016/j.jpedp.2017.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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102
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Tsachouridou O, Christaki E, Skoura L, Georgiou A, Nanoudis S, Vasdeki D, Ntziovara MA, Kotoreni G, Forozidou E, Tsoukra P, Germanidis G, Metallidis S. Predictors of humoral response to recommended vaccines in HIV-infected adults. Comp Immunol Microbiol Infect Dis 2017; 54:27-33. [PMID: 28915998 DOI: 10.1016/j.cimid.2017.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 07/17/2017] [Accepted: 07/28/2017] [Indexed: 02/07/2023]
Abstract
Humoral response to vaccination has been found to be inadequate in individuals infected with the human immunodeficiency virus (HIV). We retrospectively assessed antibody responses to three routinely recommended vaccines, against hepatitis B, hepatitis A and S. pneumoniae, in HIV-infected individuals. Data regarding age at HIV diagnosis, years of infection, sex, nationality, HIV mode of transmission, CD4 cell count, nadir CD4 count, plasma viral load, HIV stage, insurance status, educational level and treatment with Highly Active Antiretroviral Therapy (HAART) were collected. Univariate and multivariate analysis was performed in order to detect factors associated with response to vaccination. 437 patients were assessed for hepatitis B, 627 patients for hepatitis A and 66 patients for S. pneumoniae serologic vaccine responsiveness. Regarding hepatitis B and hepatitis A, education level and insurance status were the only predictors of response. As for S. pneumoniae vaccination HAART and control of viremia were correlated with better response to vaccination.
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Affiliation(s)
- Olga Tsachouridou
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Eirini Christaki
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Lemonia Skoura
- Microbiology Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Adamantini Georgiou
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece.
| | - Sideris Nanoudis
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Dimitra Vasdeki
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Maria-Anna Ntziovara
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Georgia Kotoreni
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Evropi Forozidou
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Paraskevi Tsoukra
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Georgios Germanidis
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
| | - Symeon Metallidis
- First Department of Internal Medicine, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Greece
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Frosch AE, Odumade OA, Taylor JJ, Ireland K, Ayodo G, Ondigo B, Narum DL, Vulule J, John CC. Decrease in Numbers of Naive and Resting B Cells in HIV-Infected Kenyan Adults Leads to a Proportional Increase in Total and Plasmodium falciparum-Specific Atypical Memory B Cells. THE JOURNAL OF IMMUNOLOGY 2017; 198:4629-4638. [PMID: 28526680 DOI: 10.4049/jimmunol.1600773] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 04/17/2017] [Indexed: 11/19/2022]
Abstract
Human immunodeficiency virus type 1 (HIV-1) infection is associated with B cell activation and exhaustion, and hypergammaglobulinemia. How these changes influence B cell responses to coinfections such as malaria is poorly understood. To address this, we compared B cell phenotypes and Abs specific for the Plasmodium falciparum vaccine candidate apical membrane Ag-1 (AMA1) in HIV-infected and uninfected adults living in Kenya. Surprisingly, HIV-1 infection was not associated with a difference in serum AMA1-specific Ab levels. HIV-infected individuals had a higher proportion of total atypical and total activated memory B cells (MBCs). Using an AMA1 tetramer to detect AMA1-specific B cells, HIV-infected individuals were also shown to have a higher proportion of AMA1-specific atypical MBCs. However, this proportional increase resulted in large part from a loss in the number of naive and resting MBCs rather than an increase in the number of atypical and activated cells. The loss of resting MBCs and naive B cells was mirrored in a population of cells specific for an Ag to which these individuals were unlikely to have been chronically exposed. Together, the data show that changes in P. falciparum Ag-specific B cell subsets in HIV-infected individuals mirror those in the overall B cell population, and suggest that the increased proportion of atypical MBC phenotypes found in HIV-1-infected individuals results from the loss of naive and resting MBCs.
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Affiliation(s)
- Anne E Frosch
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN 55455;
| | - Oludare A Odumade
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN 55455
| | - Justin J Taylor
- Department of Microbiology, Center for Immunology, University of Minnesota Medical School, Minneapolis, MN 55455.,Fred Hutchinson Cancer Research Center, Seattle, WA 98109
| | - Kathleen Ireland
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN 55455
| | - George Ayodo
- Kenyan Medical Research Institute, Kisumu, Kenya
| | - Bartholomew Ondigo
- Kenyan Medical Research Institute, Kisumu, Kenya.,Department of Biochemistry and Molecular Biology, Egerton University, Njoro, Kenya.,Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - David L Narum
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD 20852; and
| | - John Vulule
- Kenyan Medical Research Institute, Kisumu, Kenya
| | - Chandy C John
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN 55455.,Indiana University School of Medicine, Indianapolis, IN 46202
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104
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Levin MJ, Huang S, Moscicki AB, Song LY, Read JS, Meyer WA, Saah AJ, Richardson K, Weinberg A. Four-year persistence of type-specific immunity after quadrivalent human papillomavirus vaccination in HIV-infected children: Effect of a fourth dose of vaccine. Vaccine 2017; 35:1712-1720. [PMID: 28238631 DOI: 10.1016/j.vaccine.2017.02.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 02/02/2017] [Accepted: 02/09/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Although HIV-infected children are recommended to receive quadrivalent human papillomavirus vaccine (QHPV) there is limited information on their response to QHPV. This study in HIV-infected children, evaluated the magnitude and duration of immune responses to QHPV. This report describes type-specific serum antibody responses over a 4-to-5year period after either 3 or 4 doses of QHPV. DESIGN/METHODS HIV-infected children, ages 7-to-11years, received 3 doses of QHPV (n=96) or placebo (n=30). At 72weeks QHPV recipients received a fourth dose (n=84), while placebo recipients began the 3-dose QHPV schedule (n=27). HPV serotype-specific antibody was determined, by competitive Luminex immunoassay (cLIA) and IgG Luminex immunoassay, at 2, 3.5, and 4-to-5years after the last dose of QHPV in each treatment arm. RESULTS At 4-to-5years after the last dose of QHPV, antibody titers were significantly higher in 4-dose than in 3-dose group. However, the proportion of vaccinees with a seroresponse in the cLIA assay was not different between the two groups (86-93% for HPV types 6, 11, and 16, and 64% for HPV type 18). These results were very similar to the seroresponse rate in these HIV-infected children at 1month after completing vaccination. CONCLUSIONS Children with well-controlled HIV infection who receive 3 doses of the QHPV vaccine maintain seropositivity and antibody levels that are generally similar to children of the same age who are not HIV-infected. Antibody titer correlated strongly with low log HIV RNA, low CD8%, and high CD4%. Additionally, a fourth dose of vaccine in HIV-infected children produces a marked rise in antibody characteristic of an anamnestic response and persistence of high antibody levels. Study identification: IMPAACT P1085 (V501-021). CLINICALTRIALS.GOV identifier: NCT01206556.
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Affiliation(s)
- Myron J Levin
- Section of Pediatric Infectious Diseases, Departments of Pediatrics and Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States.
| | - Sharon Huang
- Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, MA 02115, United States
| | - Anna-Barbara Moscicki
- Department of Pediatrics, University of California Los Angeles, Los Angeles, CA 19954, United States
| | - Lin-Ye Song
- Formerly Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, MA 02115, United States; Office of Science, Food & Drug Administration; Silver Spring, MD 20993, United States
| | - Jennifer S Read
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD, United States
| | | | | | - Kelly Richardson
- Section of Pediatric Infectious Diseases, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States
| | - Adriana Weinberg
- Section of Pediatric Infectious Diseases, Departments of Pediatrics, Medicine, and Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States
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105
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Frésard A, Gagneux-Brunon A, Lucht F, Botelho-Nevers E, Launay O. Immunization of HIV-infected adult patients - French recommendations. Hum Vaccin Immunother 2016; 12:2729-2741. [PMID: 27409293 PMCID: PMC5137523 DOI: 10.1080/21645515.2016.1207013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 05/25/2016] [Accepted: 06/24/2016] [Indexed: 02/06/2023] Open
Abstract
Human immunodeficiency virus (HIV)-infected patients remain at increased risk of infection including vaccine-preventable diseases. Vaccines are therefore critical components in the protection of HIV-infected patients from an increasing number of preventable diseases. However, missed opportunities for vaccination among HIV-infected patients persist and vaccine coverage in this population could be improved. This article presents the French recommendations regarding immunization of HIV-infected adults in the light of the evidence-based literature on the benefits and the potential risks of vaccines among this vulnerable population.
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Affiliation(s)
- Anne Frésard
- Department of Infectious Diseases, CHU Saint-Etienne, Saint-Etienne, France
- Inserm, CIC 1408, St-Etienne, France
| | - Amandine Gagneux-Brunon
- Department of Infectious Diseases, CHU Saint-Etienne, Saint-Etienne, France
- Inserm, CIC 1408, St-Etienne, France
| | - Frédéric Lucht
- Department of Infectious Diseases, CHU Saint-Etienne, Saint-Etienne, France
- Inserm, CIC 1408, St-Etienne, France
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France
| | - Elisabeth Botelho-Nevers
- Department of Infectious Diseases, CHU Saint-Etienne, Saint-Etienne, France
- Inserm, CIC 1408, St-Etienne, France
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France
| | - Odile Launay
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France
- Inserm, CIC 1417, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Department of Infectious Diseases, CIC Cochin Pasteur, Paris, France
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106
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Heyderman RS, Madhi SA, French N, Cutland C, Ngwira B, Kayambo D, Mboizi R, Koen A, Jose L, Olugbosi M, Wittke F, Slobod K, Dull PM. Group B streptococcus vaccination in pregnant women with or without HIV in Africa: a non-randomised phase 2, open-label, multicentre trial. THE LANCET. INFECTIOUS DISEASES 2016; 16:546-555. [PMID: 26869376 PMCID: PMC4835545 DOI: 10.1016/s1473-3099(15)00484-3] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 11/13/2015] [Accepted: 11/17/2015] [Indexed: 12/20/2022]
Abstract
Background Neonates born to women infected with HIV are at increased risk for invasive group B streptococcus (GBS) disease. We aimed to compare safety and immunogenicity of trivalent glycoconjugate GBS vaccine in pregnant women with and without HIV in Malawi and South Africa. Methods In our non-randomised phase 2, open-label, multicentre study, we recruited pregnant women attending two antenatal clinics, one in Blantyre, Malawi, and one in Soweto, Johannesburg, South Africa. Participants were divided into three groups on the basis of their HIV infection status (no infection, infection and high CD4 cell count [>350 cells per μL], and infection and low CD4 cell count [>50 to ≤350 cells per μL]) and received a 5 μg dose of glycoconjugate GBS vaccine (serotypes Ia, Ib, and III, with CRM197 [Novartis Vaccines, Siena, Italy]) intramuscularly at 24–35 weeks' gestation. GBS serotype-specific antibody concentrations were measured before vaccination (day 1), day 15, day 31, and at delivery, and in infants at birth and day 42 of life. The primary outcomes were safety in mothers and infants and the amount of placental transfer of GBS serotype-specific antibodies from mothers to their infants. All immunogenicity and safety analyses were done on the full analysis set, including participants who, or whose mother, correctly received the vaccine and who provided at least one valid assessable serum sample. This study is registered with ClinicalTrials.gov, number NCT01412801. Findings 270 women and 266 infants were enrolled between Sept 26, 2011, and Dec 4, 2012 (90 women and 87 infants without HIV, 89 and 88 with HIV and high CD4 cell counts, and 91 and 91 with HIV and low CD4 cell counts, respectively). Seven women were lost to follow-up, six withdrew consent, one died, and two relocated. Eight infants died or were stillborn and two were lost to follow-up. Across serotypes, fold change in antibody concentrations were higher for the HIV-uninfected group than the HIV-infected groups. Transfer ratios were similar across all three groups (0·49–0·72; transfer ratio is infant geometric mean antibody concentration in blood collected within 72 h of birth divided by maternal geometric mean antibody concentration in blood collected at delivery); however, at birth, maternally derived serotype-specific antibody concentrations were lower for infants born to women infected with HIV (0·52–1·62 μg/mL) than for those born to women not infected with HIV (2·67–3·91 μg/mL). 151 (57%) of 265 women reported at least one solicited adverse reaction: 39 (45%) of 87 women with HIV and low CD4 cell counts, 52 (59%) of 88 women with HIV and high CD4 cell counts, and 60 (67%) of 90 women in the HIV-uninfected group. 49 (18%) of 269 women had at least one adverse event deemed possibly related to the vaccine (six [7%] in the HIV and low CD4 cell count group, 12 [13%] in the HIV and high CD4 cell count group, and 21 [23%] in the HIV-uninfected group), as did three (1%) of 266 neonates (zero, two [1%], and one [1%]); none of these events was regarded as serious. Interpretation The vaccine was less immunogenic in women infected with HIV than it was in those not infected, irrespective of CD4 cell count, resulting in lower levels of serotype-specific maternal antibody transferred to infants, which could reduce vaccine protection against invasive GBS disease. A validated assay and correlate of protection is needed to understand the potential protective value of this vaccine. Funding Novartis Vaccines and Diagnostics division (now part of the GlaxoSmithKline group of companies), Wellcome Trust UK, Medical Research Council: Respiratory and Meningeal Pathogens Research Unit.
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Affiliation(s)
- Robert S Heyderman
- Malawi Liverpool Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi; Division of Infection and Immunity, University College London, London, UK.
| | - Shabir A Madhi
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa; National Institute for Communicable Diseases: a division of National Health Laboratory Service, Centre for Vaccines and Immunology, Johannesburg, South Africa
| | - Neil French
- Malawi Liverpool Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi; Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - Clare Cutland
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | - Bagrey Ngwira
- Malawi Liverpool Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - Doris Kayambo
- Malawi Liverpool Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - Robert Mboizi
- Malawi Liverpool Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi
| | - Anthonet Koen
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | - Lisa Jose
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa
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Long-term immune responses and comparative effectiveness of one or two doses of 7-valent pneumococcal conjugate vaccine (PCV7) in HIV-positive adults in the era of combination antiretroviral therapy. J Int AIDS Soc 2016; 19:20631. [PMID: 26829360 PMCID: PMC4733944 DOI: 10.7448/ias.19.1.20631] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 12/04/2015] [Accepted: 12/21/2015] [Indexed: 12/04/2022] Open
Abstract
Introduction HIV infection impairs maintenance of immunological memory, yet few studies of HIV-positive adults receiving 7-valent pneumococcal conjugate vaccine (PCV7) have followed them beyond the first year. We determined and compared the durability of serological responses and the clinical outcomes of HIV-positive adults annually for five years following vaccination with one or two doses of PCV7. Methods In this non-randomized clinical trial, 221 pneumococcal vaccine-naïve HIV-positive adults receiving one (n=109) or two doses four weeks apart (n=112) of PCV7 between 2008 and 2010 were longitudinally followed for evaluation of significant serological response and for episodes of pneumonia and invasive pneumococcal disease. Results At the time of vaccination, the two groups were well matched for age, risk factors, combination antiretroviral therapy (cART) coverage, CD4 count and plasma HIV RNA load (PVL). At the end of five years, the CD4 counts for the one- and two-dose groups had increased from 407 and 406 to 550 and 592 cells/µL, respectively, and 82.4 and 81.6% of the participants had fully suppressed PVL. Significant immune responses to ≥2 serotypes persisted for 67.9 vs 78.6%, 64.2 vs 71.4%, 66.1 vs 71.4%, 57.8 vs 69.6% in the second, third, fourth and fifth years after one and two doses of PCV7 in the intention-to-treat analysis, respectively. In multivariate analysis, immunization with two doses of PCV7 (odds ratio (OR) 1.71, 95% confidence interval (CI) 1.10 to 2.65, p=0.016), concurrent cART (OR 2.16, 95% CI 1.16 to 4.00, p=0.015) and CD4 proliferation (OR 1.12, 95% CI 1.01 to 1.27, p=0.031) were predictive of persistent serological responses in the fifth year. Only one patient in the one-dose group had documented pneumococcal pneumonia (non-bacteraemic) and none had invasive pneumococcal disease in the 6.5 years of follow-up. Conclusions One or two doses of PCV7 achieve durable seroprotective responses in HIV-treated participants; however, two doses may be more robust than one dose in a larger study population or in real-world populations with less cART coverage.
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108
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An immunization update for HIV-infected adults in the United States: review of the literature. J Assoc Nurses AIDS Care 2015; 26:201-7. [PMID: 25665888 DOI: 10.1016/j.jana.2014.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 11/17/2014] [Indexed: 01/22/2023]
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Lee KY, Tsai MS, Kuo KC, Tsai JC, Sun HY, Cheng AC, Chang SY, Lee CH, Hung CC. Pneumococcal vaccination among HIV-infected adult patients in the era of combination antiretroviral therapy. Hum Vaccin Immunother 2015; 10:3700-10. [PMID: 25483681 DOI: 10.4161/hv.32247] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
HIV-infected patients remain at higher risk for pneumococcal disease than the general population despite immune reconstitution and suppression of HIV replication with combination antiretroviral therapy. Vaccination with 23-valent pneumococcal polysaccharide vaccine (PPV23) composed of T-cell-independent antigens has been recommended to reduce the risk of pneumococcal disease in HIV-infected adults. However, given the heterogeneity of study design, execution and subjects enrolled, studies examining serological responses to PPV23 yielded conflicting results and observational studies of clinical effectiveness only provided moderate evidence to support the routine use of PPV23 in HIV-infected adults. Pneumococcal conjugate vaccine (PCV), with conjugation of the capsular polysaccharide to a protein carrier, is more immunogenic than PPV23 and has been demonstrated to protect against pneumococcal disease in HIV-infected children and recurrent invasive pneumococcal disease in HIV-infected adolescents and adults. Guidelines have recently been revised to recommend that HIV-infected patients aged 19 y or older receive one dose of 13-valent pneumococcal conjugate vaccine (PCV13) followed by a booster vaccination with PPV23. In this paper, we review the studies using different vaccination strategies to improve immunogenicity among HIV-infected adult patients.
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Key Words
- ACIP, Advisory Committee on Immunization Practices
- AIDS
- ART, antiretroviral therapy
- DHHS, Department of Health and Human Services
- EACS, European AIDS Clinical Society
- ELISA, enzyme-linked immunosorbent assay
- GMT, geometric mean titer
- IPD, invasive pneumococcal disease
- NA, not available
- OPA, opsonophagocytic activity
- PCV, pneumococcal conjugate vaccine
- PCV13, 13-valent pneumococcal conjugate vaccine
- PCV7, 7-valent pneumococcal conjugate vccine
- PPV, pneumococcal polysaccharide vaccine
- PPV23, 23-valent pneumococcal polysaccharide vaccine
- PVL, plasma HIV RNA load
- Streptococcus pneumoniae
- TLR, toll-like receptor
- cART, combination antiretroviral therapy
- immunodeficiency
- immunogenicity
- invasive pneumococcal disease
- pneumococcal conjugate vaccine
- pneumococcal disease
- pneumococcal polysaccharide vaccine
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Affiliation(s)
- Kuan-Yeh Lee
- a Department of Internal Medicine ; National Taiwan University Hospital; Hsin-Chu Branch ; Hsin-Chu , Taiwan
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Diphtheria, tetanus, poliomyelitis, yellow fever and hepatitis B seroprevalence among HIV1-infected migrants. Results from the ANRS VIHVO vaccine sub-study. Vaccine 2015. [PMID: 26209841 DOI: 10.1016/j.vaccine.2015.07.036] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Few data are available on the seroprotection status of HIV1-infected patients with respect to vaccine-preventable diseases. OBJECTIVE To describe, in a population of HIV1-infected migrants on stable, effective ART therapy, the seroprevalence of diphtheria, poliomyelitis, tetanus, yellow fever antibodies and serostatus for hepatitis B, and to identify factors associated with seroprotection. Vaccine responses against diphtheria, tetanus, poliomyelitis and yellow fever were also studied. METHODS Sub-Saharan African patients participating in the ANRS-VIHVO cohort were enrolled prior to travel to their countries of origin. Serologic analyses were performed in a central laboratory before and after the trip. Univariate and multivariate logistic regression was used to identify factors associated with initial seroprotection. RESULTS 250 patients (99 men and 151 women) were included in the seroprevalence study. Median age was 45 years (IQR 39-52), median CD4 cell count was 440/μL (IQR 336-571), and 237 patients (95%) had undetectable HIV1 viral load. The initial seroprevalence rates were 69.0% (95%CI 63.2-74.7) for diphtheria, 70.7% (95%CI 65.0-76.3) for tetanus, and 85.9% (95%CI 81.6-90.2) for yellow fever. Only 64.4% (95%CI 58.5-70.3) of patients had protective antibody titers against all three poliomyelitis vaccine strains before travel. No serological markers of hepatitis B were found in 18.6% of patients (95%CI 13.7-23.3). Patient declaration of prior vaccination was the only factor consistently associated with initial seroprotection. CONCLUSIONS We found a low prevalence of seroprotection against diphtheria, poliomyelitis, tetanus and hepatitis B. HIV infected migrants living in France and traveling to their native countries need to have their vaccine schedule completed.
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Tsachouridou O, Skoura L, Zebekakis P, Margariti A, Georgiou A, Daniilidis M, Malisiovas N, Metallidis S. The controversial impact of B cells subsets on immune response to pneumococcal vaccine in HIV-1 patients. Int J Infect Dis 2015; 38:24-31. [PMID: 26192868 DOI: 10.1016/j.ijid.2015.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 07/05/2015] [Accepted: 07/09/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Chronic HIV infection leads to severe perturbations of the B cell populations and hypo-responsiveness to vaccines. The associations between circulating B cell subpopulations and the antibody response to pneumococcal polysaccharide vaccine in antiretroviral-naïve and treated patients were studied. METHODS Sixty-six HIV-infected adults were grouped according to antiretroviral therapy (ART) and CD4+ cell count; 31 were ART-naïve and 35 were ART-treated, and they were matched for age, CD4 cell count, and duration of HIV infection. All subjects were immunized with the 23-valent polysaccharide vaccine against Streptococcus pneumoniae. Pre- and post-vaccination B cell subpopulations were assessed by flow cytometry. Serum IgG concentrations for vaccine serotypes were quantified by ELISA at baseline and at 4 and 48 weeks post-vaccination. RESULTS Patients under highly active antiretroviral therapy (HAART) had significantly higher antibody levels against pneumococcal vaccine antigens, while an adequate number of patients responded to vaccination. Memory B cells were diminished over time, although treated patients maintained higher levels of all subsets studied, with the exception of activated memory and isotype-switched memory B cells. CONCLUSIONS Low concentrations of total B cells and exhausted memory B cells was the strongest independent predictor of poor pneumococcal vaccine responsiveness, emphasizing that B cell subset disturbances are associated with a poor vaccine response among HIV-infected patients.
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Affiliation(s)
- Olga Tsachouridou
- 1st Internal Medicine Department, Infectious Diseases Division, Medical School, Aristotle University of Thessaloniki, 1, Stilponos Kyriakidi Str, 54636, Thessaloniki, Greece.
| | - Lemonia Skoura
- 1st Internal Medicine Department, Infectious Diseases Division, Medical School, Aristotle University of Thessaloniki, 1, Stilponos Kyriakidi Str, 54636, Thessaloniki, Greece
| | - Pantelis Zebekakis
- 1st Internal Medicine Department, Infectious Diseases Division, Medical School, Aristotle University of Thessaloniki, 1, Stilponos Kyriakidi Str, 54636, Thessaloniki, Greece
| | - Apostolia Margariti
- National AIDS Reference Centre of Northern Greece, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Adamantini Georgiou
- 1st Internal Medicine Department, Infectious Diseases Division, Medical School, Aristotle University of Thessaloniki, 1, Stilponos Kyriakidi Str, 54636, Thessaloniki, Greece
| | - Michael Daniilidis
- 1st Internal Medicine Department, Infectious Diseases Division, Medical School, Aristotle University of Thessaloniki, 1, Stilponos Kyriakidi Str, 54636, Thessaloniki, Greece
| | - Nikolaos Malisiovas
- National AIDS Reference Centre of Northern Greece, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Symeon Metallidis
- 1st Internal Medicine Department, Infectious Diseases Division, Medical School, Aristotle University of Thessaloniki, 1, Stilponos Kyriakidi Str, 54636, Thessaloniki, Greece
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112
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Antiviral Innate Immune Activation in HIV-Infected Adults Negatively Affects H1/IC31-Induced Vaccine-Specific Memory CD4+ T Cells. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2015; 22:688-96. [PMID: 25924764 DOI: 10.1128/cvi.00092-15] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 04/19/2015] [Indexed: 12/16/2022]
Abstract
Tuberculosis (TB) remains a global health problem, with vaccination being a necessary strategy for disease containment and elimination. A TB vaccine should be safe and immunogenic as well as efficacious in all affected populations, including HIV-infected individuals. We investigated the induction and maintenance of vaccine-induced memory CD4(+) T cells following vaccination with the subunit vaccine H1/IC31. H1/IC31 was inoculated twice on study days 0 and 56 among HIV-infected adults with CD4(+) lymphocyte counts of >350 cells/mm(3). Whole venous blood stimulation was conducted with the H1 protein, and memory CD4(+) T cells were analyzed using intracellular cytokine staining and polychromatic flow cytometry. We identified high responders, intermediate responders, and nonresponders based on detection of interleukin-2 (IL-2), tumor necrosis factor alpha (TNF-α), and gamma interferon (IFN-γ) expressing central (TCM) and effector memory CD4(+) T cells (TEM) 182 days after the first immunization. Amplicon-based transcript quantification using next-generation sequencing was performed to identify differentially expressed genes that correlated with vaccine-induced immune responses. Genes implicated in resolution of inflammation discriminated the responders from the nonresponders 3 days after the first inoculation. The volunteers with higher expression levels of genes involved in antiviral innate immunity at baseline showed impaired H1-specific TCM and TEM maintenance 6 months after vaccination. Our study showed that in HIV-infected volunteers, expression levels of genes involved in the antiviral innate immune response affected long-term maintenance of H1/IC31 vaccine-induced cellular immunity. (The clinical trial was registered in the Pan African Clinical Trials Registry [PACTR] with the identifier PACTR201105000289276.).
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113
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Polonsky JA, Singh B, Masiku C, Langendorf C, Kagoli M, Hurtado N, Berthelot M, Heinzelmann A, Puren A, Grais RF. Exploring HIV infection and susceptibility to measles among older children and adults in Malawi: a facility-based study. Int J Infect Dis 2014; 31:61-7. [PMID: 25499042 DOI: 10.1016/j.ijid.2014.12.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 11/17/2014] [Accepted: 12/06/2014] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND HIV infection increases measles susceptibility in infants, but little is known about this relationship among older children and adults. We conducted a facility-based study to explore whether HIV status and/or CD4 count were associated with either measles seroprotection and/or measles antibody concentration. METHODS A convenience sample was recruited comprising HIV-infected patients presenting for follow-up care, and HIV-uninfected individuals presenting for HIV testing at Chiradzulu District Hospital, Malawi, from January to September 2012. We recorded age, sex, and reported measles vaccination and infection history. Blood samples were taken to determine the CD4 count and measles antibody concentration. RESULTS One thousand nine hundred and thirty-five participants were recruited (1434 HIV-infected and 501 HIV-uninfected). The majority of adults and approximately half the children were seroprotected against measles, with lower odds among HIV-infected children (adjusted odds ratio 0.27, 95% confidence interval 0.10-0.69; p=0.006), but not adults. Among HIV-infected participants, neither CD4 count (p=0.16) nor time on antiretroviral therapy (p=0.25) were associated with measles antibody concentration, while older age (p<0.001) and female sex (p<0.001) were independently associated with this measure. CONCLUSIONS We found no evidence that HIV infection contributes to the risk of measles infection among adults, but HIV-infected children (including at ages older than previously reported), were less likely to be seroprotected in this sample.
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Affiliation(s)
| | - Beverley Singh
- National Institute for Communicable Diseases/National Health Laboratory Service, Johannesburg, South Africa
| | | | | | | | | | | | | | - Adrian Puren
- National Institute for Communicable Diseases/National Health Laboratory Service, Johannesburg, South Africa; Division of Virology and Communicable Diseases, University of the Witwatersrand, Johannesburg, South Africa
| | - Rebecca F Grais
- Epicentre, Paris, France, 8 rue saint Sabin, 75011 Paris, France
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114
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Kagina BM, Wiysonge CS, Lesosky M, Madhi SA, Hussey GD. Safety of licensed vaccines in HIV-infected persons: a systematic review protocol. Syst Rev 2014; 3:101. [PMID: 25212760 PMCID: PMC4163552 DOI: 10.1186/2046-4053-3-101] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 08/26/2014] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Safety of vaccines remains a cornerstone of building public trust on the use of these cost-effective and life-saving public health interventions. In some settings, particularly Sub-Saharan Africa, there is a high prevalence of HIV infection and a high burden of vaccine-preventable diseases. There is evidence suggesting that the immunity induced by some commonly used vaccines is not durable in HIV-infected persons, and therefore, repeated vaccination may be considered to ensure optimal vaccine-induced immunity in this population. However, some vaccines, particularly the live vaccines, may be unsafe in HIV-infected persons. There is lack of evidence on the safety profile of commonly used vaccines among HIV-infected persons. We are therefore conducting a systematic review to assess the safety profile of routine vaccines administered to HIV-infected persons. METHODS/DESIGN We will select studies conducted in any setting where licensed and effective vaccines were administered to HIV-infected persons. We will search for eligible studies in PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, Africa-Wide, PDQ-Evidence and CINAHL as well as reference lists of relevant publications. We will screen search outputs, select studies and extract data in duplicate, resolving discrepancies by discussion and consensus. DISCUSSION Globally, immunisation is a major public health strategy to mitigate morbidity and mortality caused by various infectious disease-causing agents. In general, there are efforts to increase vaccination coverage worldwide, and for these efforts to be successful, safety of the vaccines is paramount, even among people living with HIV, who in some situations may require repeated vaccination. Results from this systematic review will be discussed in the context of the safety of routine vaccines among HIV-infected persons. From the safety perspective, we will also discuss whether repeat vaccination strategies may be feasible among HIV-infected persons. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42014009794.
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Affiliation(s)
- Benjamin M Kagina
- Vaccines for Africa Initiative, Division of Medical Microbiology and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town 7700, South Africa.
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115
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Grabmeier-Pfistershammer K, Poeppl W, Herkner H, Touzeau-Roemer V, Huschka E, Rieger A, Burgmann H. High need for MMR vaccination in HIV infected adults in Austria. Vaccine 2014; 32:6020-3. [PMID: 25203449 DOI: 10.1016/j.vaccine.2014.07.114] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 06/26/2014] [Accepted: 07/01/2014] [Indexed: 10/24/2022]
Abstract
Current guidelines recommend screening for HIV infected patients susceptible for vaccine preventable diseases and offering of immunization. However, data regarding the vaccination coverage among this group are largely missing. This study analyzed the serostatus for Measles, Mumps and Rubella of more than 700 HIV infected patients residing in Austria. These patients were representative for the Austrian HIV cohort regarding sex, age, transmission risk and HIV progression markers. 73.6% were on suppressive HAART, mean CD4 cell count was 603c/μl. Seronegativity was 8.4% for Measles, 33.4% for Mumps and 18.8% for Rubella. In total, out of the 713 HIV infected adults analyzed, almost half (47.8%) would require MMR vaccination. In a multivariate analysis migration was significantly associated with seronegativity for Measles (OR 0.5, CI 0.27-0.9) and Mumps (OR 0.57, CI 0.39-0.81). Importantly due to the well preserved immune status of nearly all participants vaccination would be feasible in the majority of the seronegative patients. Thus, a proactive approach would largely reduce the number of patients at risk for vaccine-preventable diseases.
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Affiliation(s)
- K Grabmeier-Pfistershammer
- Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University Vienna, Austria.
| | - W Poeppl
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Austria
| | - H Herkner
- Department of Emergency Medicine, Medical University of Vienna, Austria
| | - V Touzeau-Roemer
- Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University Vienna, Austria
| | - Emilia Huschka
- Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University Vienna, Austria
| | - A Rieger
- Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University Vienna, Austria
| | - H Burgmann
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Austria
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