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Boum Y, Juan-Giner A, Hitchings M, Soumah A, Strecker T, Sadjo M, Cuthbertson H, Hayes P, Tchaton M, Jemmy JP, Clarck C, King D, Faga EM, Becker S, Halis B, Gunnstein N, Carroll M, Røttingen JA, Kondé MK, Doumbia M, Henao-Restrepo AM, Kieny MP, Cisse M, Draguez B, Grais RF. Humoral and cellular immune response induced by rVSVΔG-ZEBOV-GP vaccine among frontline workers during the 2013-2016 West Africa Ebola outbreak in Guinea. Vaccine 2020; 38:4877-4884. [PMID: 32499066 PMCID: PMC7306162 DOI: 10.1016/j.vaccine.2020.04.066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 04/26/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND As part of a Phase III trial with the Ebola vaccine rVSVΔG-ZEBOV-GP in Guinea, we invited frontline workers (FLWs) to participate in a sub-study to provide additional information on the immunogenicity of the vaccine. METHODS We conducted an open-label, non-randomized, single-arm immunogenicity evaluation of one dose of rVSVΔG-ZEBOV-GP among healthy FLWs in Guinea. FLWs who refused vaccination were offered to participate as a control group. We followed participants for 84 days with a subset followed-up for 180 days. The primary endpoint was immune response, as measured by ELISA for ZEBOV-glycoprotein-specific antibodies (ELISA-GP) at 28 days. We also conducted neutralization, whole virion ELISA and enzyme-linked immunospot (ELISPOT) assay for cellular response. RESULTS A total of 1172 participants received one dose of vaccine and were followed-up for 84 days, among them 114 participants were followed-up for 180 days. Additionally, 99 participants were included in the control group and followed up for 180 days. Overall, 86.4% (95% CI 84.1-88.4) of vaccinated participants seroresponded at 28 days post-vaccination (ELISA- GP) with 65% of these seroresponding at 14 days post-vaccination. Among those who seroresponded at 28 days, 90.7% (95% CI 82.0-95.4) were still seropositive at 180 days. The proportion of seropositivity in the unvaccinated group was 0.0% (95% CI 0.0-3.8) at 28 days and 5.4% (95% CI 2.1-13.1) at 180 days post-vaccination. We found weak correlation between ELISA-GP and neutralization at baseline but significant pairwise correlation at 28 days post-vaccination. Among samples analysed for cellular response, only 1 (2.2%) exhibited responses towards the Zaire Ebola glycoprotein (Ebola GP ≥ 10) at baseline, 10 (13.5%) at day 28 post-vaccination and 27 (48.2%) at Day 180. CONCLUSIONS We found one dose of rVSVΔG-ZEBOV-GP to be highly immunogenic at 28- and 180-days post vaccination among frontline workers in Guinea. We also found a cellular response that increased with time.
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Affiliation(s)
| | | | - Matt Hitchings
- Center for Communicable Disease Dynamics and Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | | | - Thomas Strecker
- Institute of Virology, Philipps University, Marburg, Germany
| | - Mariama Sadjo
- Centre Hospital-Universitaire de Donka, Conakry, Guinea
| | | | - Peter Hayes
- Division of Medicine, Department of Infectious Diseases, Imperial College London, UK
| | | | - Jean-Paul Jemmy
- Médecins Sans Frontières-Operational Center Belgium, Brussels, Belgium
| | - Carolyn Clarck
- Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Deborah King
- Division of Medicine, Department of Infectious Diseases, Imperial College London, UK
| | | | - Stephan Becker
- Institute of Virology, Philipps University, Marburg, Germany
| | - Bassam Halis
- Public Health England, National Infection Service, Porton Down, UK
| | - Norheim Gunnstein
- Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway
| | - Miles Carroll
- Public Health England, National Infection Service, Porton Down, UK
| | - John-Arne Røttingen
- Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway; Department of Health and Society, University of Oslo, Norway; Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA; Coalition for Epidemic Preparedness Innovations, Care of Norwegian Institute of Public Health, Oslo, Norway; Research Council of Norway, Oslo, Norway
| | - Mandy Kader Kondé
- Center of Excellence for Training, Research On Malaria & Priority Diseases In Guinea, Conakry, Guinea
| | | | | | | | - Mohamed Cisse
- Centre Hospital-Universitaire de Donka, Conakry, Guinea
| | - Bertrand Draguez
- Médecins Sans Frontières-Operational Center Belgium, Brussels, Belgium
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Wanda F, Nkemenang P, Ehounou G, Tchaton M, Comte E, Toutous Trellu L, Masouyé I, Christinet V, O'Brien DP. Clinical features and management of a severe paradoxical reaction associated with combined treatment of Buruli ulcer and HIV co-infection. BMC Infect Dis 2014; 14:423. [PMID: 25073531 PMCID: PMC4122778 DOI: 10.1186/1471-2334-14-423] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 07/15/2014] [Indexed: 12/04/2022] Open
Abstract
Background In West and Central Africa Buruli ulcer (BU) and HIV co-infection is increasingly recognised and management of these two diseases combined is an emerging challenge for which there is little published information. In this case we present a severe paradoxical reaction occurring after commencing antibiotic treatment for BU combined with antiretroviral therapy for HIV, and describe its clinical features and management. This includes to our knowledge the first reported use of prednisolone in Africa to manage a severe paradoxical reaction related to BU treatment. Case presentation A 30 year old immunosuppressed HIV positive man from Cameroon developed a severe paradoxical reaction 24 days after commencing antibiotic treatment for BU and 14 days after commencing antiretroviral therapy for HIV. Oral prednisolone was successfully used to settle the reaction and prevent further tissue loss. The antiretroviral regimen was continued unchanged and the BU antibiotic treatment not prolonged beyond the recommended duration of 8 weeks. A second small local paradoxical lesion developed 8 months after starting antibiotics and settled with conservative treatment only. Complete healing of lesions occurred and there was no disease recurrence 12 months after commencement of treatment. Conclusions Clinicians should be aware that severe paradoxical reactions can occur during the treatment of BU/HIV co-infected patients. Prednisolone was effectively and safely used to settle the reaction and minimize the secondary tissue damage. Electronic supplementary material The online version of this article (doi:10.1186/1471-2334-14-423) contains supplementary material, which is available to authorized users.
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