Immunogenicity of Hepatitis B Vaccine in HIV Exposed Uninfected Infants

Singh, Dharmendra Kumar; Kumar, Rajneesh; Rai, Ruchi; Maurya, Manisha; Bhargava, Anudita

doi:10.1007/s12098-015-1905-1

Cited by 5 publications

(3 citation statements)

References 8 publications

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“…Among a cohort of Brazilian HEU infants vaccinated with HBV (at birth, 1 and 6 months), 6.7% of HEU infants were non-responders to HBV (HBsAg IgG <10 mIU/ml) 1 month after the third dose of HBV ( 65 ). This study supports earlier findings which reported that about 8% of HEU infants did not respond to HBV ( 66 ) and more recent data from India which found that of HEU infants vaccinated with three doses of recombinant HBV (at 6, 10, and 14 weeks), 11.5% were non-responders 3 months after the third dose of the vaccine ( 67 ). The reported prevalence of non-responders to HBV among HEU infants, 6.7–11.5% ( 65 – 67 ) is comparable to the 5–10% of non-responders reported among healthy population ( 73 ).…”

Section: Adaptive Immune System Of Heu Infantssupporting

confidence: 91%

The Immune System of HIV-Exposed Uninfected Infants

et al. 2016

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Infants born to human immunodeficiency virus (HIV) infected women are HIV-exposed but the majority remains uninfected [i.e., HIV-exposed uninfected (HEU)]. HEU infants suffer greater morbidity and mortality from infections compared to HIV-unexposed (HU) peers. The reason(s) for these worse outcomes are uncertain, but could be related to an altered immune system state. This review comprehensively summarizes the current literature investigating the adaptive and innate immune system of HEU infants. HEU infants have altered cell-mediated immunity, including impaired T-cell maturation with documented hypo- as well as hyper-responsiveness to T-cell activation. And although prevaccination vaccine-specific antibody levels are often lower in HEU than HU, most HEU infants mount adequate humoral immune response following primary vaccination with diphtheria toxoid, haemophilus influenzae type b, whole cell pertussis, measles, hepatitis B, tetanus toxoid, and pneumococcal conjugate vaccines. However, HEU infants are often found to have lower absolute neutrophil counts as compared to HU infants. On the other hand, an increase of innate immune cytokine production and expression of co-stimulatory markers has been noted in HEU infants, but this increase appears to be restricted to the first few weeks of life. The immune system of HEU children beyond infancy remains largely unexplored.

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Section: Adaptive Immune System Of Heu Infantssupporting

confidence: 91%

The Immune System of HIV-Exposed Uninfected Infants

et al. 2016

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“…While this idea is still speculative in the setting of malaria, HIV-exposed, uninfected infants are at a high risk of developing other infections during infancy [106,107] and for example, exhibit impaired B and T cell responses against Hepatitis B, Mycobacterium tuberculosis and Tetanus Toxoid vaccines [108–110]. Indeed, some data suggests that in utero malaria exposure could impact susceptibility to childhood diseases and vaccine responsiveness [97]; however, future studies are warranted to better address this important issue.…”

Section: Future Challenges and Perspectivesmentioning

confidence: 99%

Impact of In Utero Exposure to Malaria on Fetal T Cell Immunity

Odorizzi

Feeney

2016

Trends in Molecular Medicine

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Pregnancy-associated malaria, including placental malaria, causes significant morbidity and mortality worldwide. Recently, it has been suggested that in utero exposure of the fetus to malaria antigens may negatively impact the developing immune system and result in tolerance to malaria. Here, we review our current knowledge of fetal immunity to malaria, focusing on the dynamic interactions between maternal malaria infection, placental development and the fetal immune system. A better understanding of the long-term impact of in utero malaria exposure on the development of natural immunity to malaria, immune responses to other childhood pathogens, and vaccine immunogenicity is urgently needed. This may guide the implementation of novel chemoprevention strategies during pregnancy and facilitate the push towards malaria vaccines. KeywordsPlacental Malaria; Pregnancy-associated malaria; Fetal Immune System; Fetal Tolerance Global Impact of Pregnancy-Associated MalariaMalaria (see Glossary) remains one of the leading causes of morbidity and mortality worldwide, resulting in an estimated 500,000 deaths each year [1,2]. Pregnant women, infants and young children are the most vulnerable populations and account for the majority of infections. More than 125 million pregnancies occur annually in regions at risk for malaria transmission and one in four pregnant women in sub-Saharan Africa have evidence of malaria infection at parturition [1,2]. Moreover, pregnant women are at a greater risk for malaria infection relative to non-pregnant adults, experiencing higher levels of parasitemia and symptomatic disease [3,4]. Pregnancy-associated malaria, including placental malaria (PM), can have profound consequences on the developing fetus, leading to intrauterine growth retardation (IUGR), low birth weight (LBW), prematurity, miscarriage, and stillbirth [1,5].Corresponding author contact Information: margaret.feeney@ucsf.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptInfants and young children are highly susceptible to malaria during the first few years of life. In 2015, approximately 300,000 children under the age of five succumbed to malaria, with the highest mortality rates occurring in Africa [2]. Several epidemiological studies have found that the incidence of malaria during infancy and childhood is even higher among infants born to mothers with PM [6][7][8]. While this may partly due to the fact that infants of highly-exposed mothers are themselves at greater risk of environmental exposure, ...

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“…The concentration of anti-HBs for each participant was calculated from a standard curve generated according to the manufacturer's instructions. Anti-HBs were categorized as i) no response, ii) < 10 mIU/ml and iii) > 10 mIU/ml and the concentration equal or greater than 10 mIU/ml was taken as the protective anti-HBs seroconversion [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43].…”

Section: Detection Of Plasma Levels Of Hbsag Specific Antibodiesmentioning

confidence: 99%

Antibody Responses Specific to Hepatitis B Virus Vaccine in Children Exposed InUtero to Antiretroviral Therapy

2019

JCEI

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The use of antiretroviral (ARV) has been one of the most effective means of preventing vertical transmission of the human immunodeficiency virus (HIV) to exposed children born of HIV infected mothers. Nevertheless, responses to childhood vaccination against Hepatitis B virus (HBV) infections remain suboptimal in HIV exposed uninfected children irrespective of maternal ARV prophylaxis. In a cross-sectional study we have assessed the impact of in-utero exposure to ARV on paediatric HBV vaccination. Anti-HBV surface antigen specific antibodies (anti-HBs abs) were measured in plasma specimens from 44 healthy children unexposed to both HIV and ARV (HU), 25 HIV-exposed uninfected children naïve to intrauterine exposure to ARV (HEU.AR -), 29 ARV and HIV-exposed uninfected children during pregnancy (HEU.ARV + ), 50 children vertically infected with HIV but naïve to intrauterine exposure to ARV (HEI.ARV -) and 22 children vertically infected with HIV with in utero exposure to ARV (HEI.ARV + ). The protective seroconversion rate after childhood HBV vaccination (anti-HBs ≥10 mUI/ml) among HEU.ARV + children (58%) was significantly lower relative to both HEU.ARVc -(100%, P=0.0010) and the healthy unexposed children (92 %, P=0.0069). Similarly, HEI.ARV + children also had significantly lower anti-HBs IgM antibody responses when compared to both HU (p=0.0003) and HEI.ARV -(0.0001) children respectively. Thus in-utero exposure to ARV probably contributes in reducing HBV vaccine antibody response rate in both HIV exposed uninfected and vertically infected children after childhood vaccination. Nevertheless, the overall impact of ARV was to improve anti-HBs IgG responses in HIV infected children suggesting a possible role in immune reconstitution leading to improved IgG antibody responses.

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Immunogenicity of Hepatitis B Vaccine in HIV Exposed Uninfected Infants

Cited by 5 publications

References 8 publications

The Immune System of HIV-Exposed Uninfected Infants

The Immune System of HIV-Exposed Uninfected Infants

Impact of In Utero Exposure to Malaria on Fetal T Cell Immunity

Antibody Responses Specific to Hepatitis B Virus Vaccine in Children Exposed InUtero to Antiretroviral Therapy

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