Serological response to 13-valent pneumococcal conjugate vaccine in children and adolescents with perinatally acquired HIV infection

Abstract

Background:Children with perinatally acquired HIV (paHIV) remain at an increased risk of pneumococcal infection despite highly active antiretroviral therapy (HAART). Beyond infancy, responses to pneumococcal conjugate vaccine (PCV) remain under-investigated. There are currently no published data on serological response to 13-valent PCV (PCV13) in the HIV-infected populations.Methods:We measured pneumococcal serotype-specific IgG in 48 paHIV-infected child patients (CP), 27 young adult healthy controls (AHC) and 30 child healthy controls (CHC). Opsonophagocytic assay (OPA) titres for three PCV13-exclusive serotypes were measured in a subset of children. Serotype-specific IgG was repeated 1 and 6 months following PCV13 vaccination of CP and AHC groups. OPA titres for four serotypes were measured at the 1-month time-point.Results:The majority of CP, CHC and AHC had serotype-specific IgG above 0.35 μg/ml at baseline, although OPA activity was undetectable for two of the three serotypes studied. Baseline IgG concentrations were significantly lower in CP than AHC for a proportion of serotypes and were strongly predictive of responses to vaccine. After adjusting for baseline, postvaccination IgG concentrations were comparable, although responses to some serotypes were impaired for CP. OPA correlated well with IgG after vaccination. Detectable HIV viral load was associated with significantly lower IgG concentration and OPA titre.Conclusion:Children with paHIV mount a robust serological response to PCV13 for most but not all vaccine serotypes. Viral load suppression with HAART and higher baseline IgG concentration are associated with higher postvaccination antibody levels. This has implications for HAART treatment and vaccination practices.

Vaccination with 10-valent pneumococcal conjugate vaccine in infants according to HIV status

“…Immune response in HIV+ children and adolescents has also been assessed for 13-valent PCV; children with perinatally-acquired HIV had mounted robust serotype-specific IgG responses 1 month after a single 13-valent PCV dose, persisting up to 6 months for most serotypes. [19] …”

HIV-associated memory B cell perturbations

“…Most of the studies use levels of antigen-specific antibodies as an index to evaluate vaccine efficacies. Among these studies, ART has been found to improve humoral immune responses to vaccination in HIV-infected individuals, especially in patients with viral suppression and higher CD4+ T cell counts [93-95]. Nevertheless, frequencies of antigen-specific memory B cells against measles vaccine are not increased in children after 5 years of ART [90], suggesting that ART alone may be incapable of restoring the depletion of antigen-specific memory B cell pools.…”

Effectiveness of Pneumococcal Conjugate Vaccination against Invasive Pneumococcal Disease among children with and those without HIV infection: A Systematic Review and Meta-Analysis

“…Although we tried to study children under 7 years of age, which was referred to as a homogeneous age group in previous studies 36,37 , our results showed that the age group can affect the efficacy and effectiveness of vaccines in both HI and HUI children. Although the study results showed that older HI children had the lowest efficacy compared to children under 2 years old, this result may be due to the length of follow-up time (around 6 years VS less than 2 years) and is not an follow-up adjusted valuable result 38 .…”