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Pediatric HIV Infection and Decreased Prevalence of OPV Point Mutations Linked to Vaccine-associated Paralytic Poliomyelitis
- Source :
- Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
- Publication Year :
- 2018
- Publisher :
- Oxford University Press, 2018.
-
Abstract
- Background Mutations associated with prolonged replication of the attenuated polioviruses found in oral poliovirus vaccine (OPV) can lead to vaccine-derived poliovirus (VDPV) and cause paralysis indistinguishable from that caused by wild poliovirus. In response, the World Health Organization has initiated the transition to exclusive use of inactivated poliovirus vaccine (IPV), with OPV administration in cases of outbreak. However, it is currently unclear how IPV-only vaccination, well known to provide humoral but not mucosal immunity, will impact the development of paralysis causing OPV variants. Children infected with human immunodeficiency virus (HIV) have been documented to show decreased mucosal immunity following OPV vaccination. Thus, HIV-infected children vaccinated with OPV may serve as proxy for children with IPV-only vaccination. Methods We conducted a prospective study of Zimbabwean infants receiving OPV as part of their routine vaccination schedule. Stool samples collected from OPV-vaccinated children serially until age 24 months were tested for OPV serotypes using a real-time polymerase chain reaction protocol that quantifies the amount of mutant OPV variants found in each sample. Results Out of 2130 stool samples collected from 402 infants 365 stool samples were OPV positive: 313 from 212 HIV-noninfected (HIV−) infants and 52 from 34 HIV-infected (HIV+) infants. HIV− infants showed significantly higher proportions of OPV mutants when compared to HIV+ infants. Conclusions HIV infection is associated with a reduced proportion of OPV vaccine associated paralytic polio mutants. These results suggest that OPV administered to individuals previously vaccinated only with IPV will show decreased propensity for OPV mutations.
- Subjects :
- 0301 basic medicine
Microbiology (medical)
Serotype
Zimbabwe
030106 microbiology
OPV
Supplement Articles
HIV Infections
medicine.disease_cause
Serogroup
World Health Organization
VAPP
03 medical and health sciences
shedding
Feces
0302 clinical medicine
medicine
Paralysis
Humans
Point Mutation
030212 general & internal medicine
Prospective Studies
Prospective cohort study
Immunization Schedule
business.industry
infants
Poliovirus
Vaccination
Outbreak
HIV
Infant
medicine.disease
Virology
3. Good health
Poliomyelitis
Virus Shedding
Poliovirus Vaccine, Inactivated
Infectious Diseases
Poliovirus Vaccine, Oral
Inactivated Poliovirus Vaccine
medicine.symptom
business
Subjects
Details
- Language :
- English
- ISSN :
- 15376591 and 10584838
- Volume :
- 67
- Issue :
- Suppl 1
- Database :
- OpenAIRE
- Journal :
- Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
- Accession number :
- edsair.doi.dedup.....cac80a8985b9da3174e9772d668a188b