Low Rates of Poliovirus Antibodies in Primary Immunodeficiency Patients on Regular Intravenous Immunoglobulin Treatment

Costa‐Carvalho, Beatriz Tavares; Sullivan, Kathleen E.; Fontes, Patrícia M.; Aimé-Nobre, Fernanda; Gonzales, Isabela G. S.; Lima, Elaine S.; Granato, Celso; Moraes-Pinto, Maria Isabel de

doi:10.1007/s10875-018-0531-x

Cited by 5 publications

(5 citation statements)

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“…Although the IVIg preparations contained sufficient titers to poliovirus [ 30 ], poliovirus excretion was observed, possibly due to irregular treatment, variable–specific antibody kinetics, and lack of T-cell-mediated immune response in PID patients. Furthermore, protection at mucosal sites is uncertain which is the main portal of entry for enteroviruses [ 31 ]. In a similar report, IVIg failed to reduce the incidence of hospital-acquired infections in the infants in a study conducted by The National Institutes of Health-sponsored Neonatal Research Network [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of Enterovirus Excretion and Identification of VDPVs in Patients with Primary Immunodeficiency in India: Outcome of ICMR–WHO Collaborative Study Phase-I

et al. 2023

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The emergence of vaccine-derived polioviruses (VDPVs) in patients with Primary Immunodeficiency (PID) is a threat to the polio-eradication program. In a first of its kind pilot study for successful screening and identification of VDPV excretion among patients with PID in India, enteroviruses were assessed in stool specimens of 154 PID patients across India in a period of two years. A total of 21.42% of patients were tested positive for enteroviruses, 2.59% tested positive for polioviruses (PV), whereas 18.83% of patients were positive for non-polio enteroviruses (NPEV). A male child of 3 years and 6 months of age diagnosed with Hyper IgM syndrome was detected positive for type1 VDPV (iVDPV1) with 1.6% nucleotide divergence from the parent Sabin strain. E21 (19.4%), E14 (9%), E11 (9%), E16 (7.5%), and CVA2 (7.5%) were the five most frequently observed NPEV types in PID patients. Patients with combined immunodeficiency were at a higher risk for enterovirus infection as compared to antibody deficiency. The high susceptibility of PID patients to enterovirus infection emphasizes the need for enhanced surveillance of these patients until the use of OPV is stopped. The expansion of PID surveillance and integration with a national program will facilitate early detection and follow-up of iVDPV excretion to mitigate the risk for iVDPV spread.

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Section: Discussionmentioning

confidence: 99%

Assessment of Enterovirus Excretion and Identification of VDPVs in Patients with Primary Immunodeficiency in India: Outcome of ICMR–WHO Collaborative Study Phase-I

et al. 2023

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“…Esta conduta poderia proporcionar uma boa alternativa para substituir as cepas de tipo selvagem no atual procedimento de avaliação do estado vacinal e da resposta imunológica para os três sorotipos virais. A avaliação da imunidade é muito importante principalmente para os pacientes imunodeprimidos, como os pacientes HIV positivos e os indivíduos que realizaram transplante de medula óssea 7 . Para estes últimos pacientes, a reconstituição da imunidade é realizada por meio de revacinação.…”

Section: /9unclassified

“…A vacina oral poliomielite (VOP) é mais fácil de ser administrada, porém, apesar de raro, pode ocorrer a reversão da virulência e causar paralisia associada aos vírus vacinais 5,6 . A reversão da virulência pode ocorrer também em pacientes com imunodeficiência primária, pois excretam o poliovírus vacinais por períodos extremamente prolongados, tornando-os capazes de causar infecção na população suceptível 7,8 . No Brasil estima-se que ocorra um caso em 5 milhões de reversão de virulência na primeira dose de vacinação e de um caso em 10 milhões, nas doses subsequentes 9 .…”

Section: Introductionunclassified

Padronização de teste para quantificar anticorpos anti-poliovírus utilizando vírus vacinal

Lima

Moraes-Pinto

Blanco

et al. 2019

Rev Inst Adolfo Lutz

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A poliomielite é uma doença endêmica no Afeganistão e no Paquistão, apesar dos esforços para ser erradicada, representando uma ameaça para outros países principalmente devido às viagens internacionais. A Organização Mundial da Saúde (OMS) tem como objetivo erradicar a poliomielite causada pelo poliovírus selvagem no mundo. O requisito essencial para a erradicação da poliomielite é a eliminação da cepa do poliovírus selvagem, que é empregada no teste padrão-ouro. Com o intuito de auxiliar na erradicação do poliovírus selvagem, o objetivo deste estudo foi modificar o teste padrão-ouro usando o poliovírus derivado da vacina oral atenuada. Foram testados 63 soros pelo ensaio de neutralização utilizando-se antígenos vacinais. A concordância do sorotipo 1 (k=0,74) foi considerada substancial, enquanto o sorotipo 2 (k=1,00) e sorotipo 3 (k= 0,95) foram consideradas quase perfeitas. A sensibilidade dos testes de soroneutralização utilizando os sorotipos 1, 2 e 3 foi de 94,83%, 100,00% e 100,00%, respectivamente. Em conclusão, o ensaio com antígenos vacinais pode ser usado como procedimento laboratorial seguro, especialmente em estudos de vigilância em larga escala.

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“…There are a few studies assessing the titers of specific immunoglobulins in patients receiving immunoglobulins, in both intravenous and subcutaneous forms. These studies focused on concentrations of pneumococcal anti polysaccharides antibodies to 23 valent vaccine serotypes, and antibodies against Hib, with a recent study measuring antibodies concentration against polio virus [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Trough Concentrations of Specific Antibodies in Primary Immunodeficiency Patients Receiving Intravenous Immunoglobulin Replacement Therapy

Hassin

Freih

Hazan

et al. 2021

JCM

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Immunoglobulin replacement therapy is a mainstay therapy for patients with primary immunodeficiency (PID). The content of these preparations was studied extensively. Nevertheless, data regarding the effective specific antibodies content (especially in the nadir period), and, in different groups of PID patients is limited. We studied trough IgG concentrations as well as anti-Pneumococcus, anti-Haemophilus influenzae b, anti-Tetanus, and anti-Measles antibody concentrations in 17 PID patients receiving intravenous immunoglobulin (IVIg) compared with healthy controls matched for age and ethnicity. We also analyzed these results according to the specific PID diagnosis: X-linked agammaglobulinemia (XLA), combined immunodeficiency (CID), and ataxia telangiectasia (AT). We recorded a higher concentration of anti-pneumococcal polysaccharide antibodies in healthy controls compared to the entire group of PID patients. We also found significantly higher anti-tetanus toxoid antibody concentrations in the XLA patients, compared to CID patients. Anti-Haemophilus Influenzae b antibody titers were overall similar between all the groups. Interestingly, there were overall low titers of anti-Measles antibodies below protective cutoff antibody concentrations in most patients as well as in healthy controls. We conclude that relying on total IgG trough levels is not necessarily a reflection of effective specific antibodies in the patient’s serum. This is especially relevant to CID patients who may have production of nonspecific antibodies. In such patients, a higher target trough IgG concentration should be considered. Another aspect worth considering is that the use of plasma from adult donors with a waning immunity for certain pathogens probably affects the concentrations of specific antibodies in IVIg preparations.

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Low Rates of Poliovirus Antibodies in Primary Immunodeficiency Patients on Regular Intravenous Immunoglobulin Treatment

Abstract: This study demonstrates the need for ongoing vigilance regarding exposure of patients with PID to poliovirus in the community.

Cited by 5 publications

References 44 publications

Assessment of Enterovirus Excretion and Identification of VDPVs in Patients with Primary Immunodeficiency in India: Outcome of ICMR–WHO Collaborative Study Phase-I

Assessment of Enterovirus Excretion and Identification of VDPVs in Patients with Primary Immunodeficiency in India: Outcome of ICMR–WHO Collaborative Study Phase-I

Padronização de teste para quantificar anticorpos anti-poliovírus utilizando vírus vacinal

Trough Concentrations of Specific Antibodies in Primary Immunodeficiency Patients Receiving Intravenous Immunoglobulin Replacement Therapy

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