1. The immunogenicity and safety of pneumococcal conjugate vaccine in human immunodeficiency virus-infected Thai children.
- Author
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Thanee C, Pancharoen C, Likitnukul S, Luangwedchakarn V, Umrod P, Phasomsap C, Apornpong T, Chuanchareon T, Butterworth O, and Puthanakit T
- Subjects
- AIDS-Related Opportunistic Infections drug therapy, AIDS-Related Opportunistic Infections epidemiology, AIDS-Related Opportunistic Infections immunology, AIDS-Related Opportunistic Infections prevention & control, Antiretroviral Therapy, Highly Active methods, Child, Preschool, HIV Infections drug therapy, HIV Infections epidemiology, HIV Infections virology, HIV-1 drug effects, Humans, Immunoglobulin G blood, Infant, Pneumococcal Infections epidemiology, Pneumococcal Infections immunology, Pneumococcal Infections microbiology, Pneumococcal Vaccines administration & dosage, Pneumococcal Vaccines immunology, Pneumococcal Vaccines therapeutic use, Prospective Studies, Streptococcus pneumoniae classification, Thailand, Treatment Outcome, Vaccines, Conjugate administration & dosage, Vaccines, Conjugate immunology, Vaccines, Conjugate therapeutic use, Antibodies, Bacterial blood, HIV Infections complications, Pneumococcal Infections prevention & control, Pneumococcal Vaccines adverse effects, Streptococcus pneumoniae immunology, Vaccines, Conjugate adverse effects
- Abstract
Background: HIV-infected children have high risk of invasive pneumococcal disease (IPD) despite receiving highly active antiretroviral therapy (HAART). This study aimed to determine the immunogenicity and safety of a 7-valent pneumococcal conjugate vaccine (PCV-7) in Thai HIV-infected children compared to HIV-exposed uninfected children., Methods: A prospective study was conducted among children 2 months to 9 years. The number of PCV-7 doses depended upon age and HIV status; 2-6 months of age: 3 doses; 7-23 months of age: 2 doses; HIV-infected child ≥24 months: 2 doses and HIV-exposed child ≥24 months: 1 dose. Serotype-specific pneumococcal IgG antibody concentrations were measured at baseline and 28 days after complete vaccination. The primary end point was the proportion of children who achieved serotype-specific IgG antibody concentration at a cut off level ≥0.35 μg/mL. Secondary end points were a 4-fold increase in serotype-specific IgG antibody, rates of adverse events and predictors for seroconversion among HIV-infected children., Results: Fifty-nine HIV-infected and 30 HIV-exposed children were enrolled. The median (IQR) age was 97 (67-111) and 61 months (51-73), respectively (p<0.001). Among HIV-infected children, current and nadir CD4 counts were 1,079 cell/mm(3) and 461 cell/mm(3), respectively. The proportion of children who achieved pneumococcal IgG ≥0.35 μg/mL was in the range of 85-98% in HIV-infected and 83-100% in HIV-exposed children depending on serotype. The lowest response was to serotype 6B in both groups. The 4-fold increase in serotype-specific IgG concentrations was similar between HIV-infected and HIV-exposed groups, except for serotype 9V (p=0.027). HIV-infected children who had a history of AIDS had a lower antibody response to serotype 23F (p=0.025). Seven (12%) HIV-infected children had a grade 3 local reaction., Conclusion: PCV-7 is highly immunogenic and safe among HIV-infected children treated with HAART. The use of the pneumococcal conjugate vaccine among HIV-infected children is encouraged in order to prevent IPD., (Copyright © 2011 Elsevier Ltd. All rights reserved.)
- Published
- 2011
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