Reduced Poliovirus vaccine neutralising-antibody titres in infants with maternal HIV-exposure

Sanz-Ramos, Marta, Manno, Daniela, Kapambwe, Mirriam, Ndumba, Ida, Musonda, Kunda G., Bates, Matthew, Chibumbya, Julia, Siame, Joshua, Monze, Mwaka, Filteau, Suzanne, Gompels, Ursula A. and Team, CIGNIS Study (2013) Reduced Poliovirus vaccine neutralising-antibody titres in infants with maternal HIV-exposure. VACCINE, 31 (16). pp. 2042-2049. ISSN 0264-410X

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Background: Maternally HIV-exposed (mHIV-EU) infants have poor health even without HIV-1 infection. The responses to vaccination are less well defined. Immunity to oral Poliovirus vaccine (OPV) was studied in Zambian infants participating in a randomised controlled trial of micronutrient fortification to improve child health. Method: Maternally HIV-unexposed and mHIV-EU infants were recruited at 6 months age and randomised to basal or enriched micronutrient-fortified diets for 12 months. HIV-exposed mother-infant pairs had received perinatal nevirapine to prevent mother-to-child-transmission. In the cohort of 597 infants, neutralising-antibody titres to OPV were analysed at 18 months with respect to micronutrient fortification, maternal or infant HIV-1 infection, and human cytomegalovirus (HCMV) infection detected by antibodies and viraemia (serum DNA). Vaccine protection was defined as log(2) titre > 3. Results: Compared to uninfected children, HIV-1-infected children had reduced neutralising antibody titres to OPV, irrespective of diet: log(2) titre difference (95% confidence interval) -3.44 (-2.41; -4.46), P < 0.01. OPV antibody titres were lower in HIV-infected children with HCMV viraemia compared to those without viraemia at 18 months, but did not reach significance: difference -2.55 (-6.10; 1.01), P = 0.14. Breast-feeding duration was independently associated with increasing OPV titre (P-value < 0.01). In mHIV-EU children there were reduced neutralising antibody titres to Poliovirus compared with maternally HIV-unexposed, irrespective of diet, maternal education and socioeconomic status: log(2) titre difference (95% confidence interval) -0.56 (-0.98; -0.15), P < 0.01. This difference was noticeably decreased after adjusting for breast-feeding duration, suggesting that in our study population less breast-feeding by HIV-positive mothers could explain the reduced OPV titres in mHIV-EU infants. Conclusion: The mHIV-EU infants had reduced polio vaccine antibody titres which were associated with reduced breast-feeding duration. This has important implications for polio eradication and control of vaccine-preventable diseases, in countries where childhood HIV-1 infection and maternal exposure are public health threats. (c) 2013 Published by Elsevier Ltd.

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Keywords:Maternal HIV exposur, Childhood HIV, Polio vaccine, Human cytomegalovirus, Micronutrient, Breast-feeding}
Subjects:A Medicine and Dentistry > A300 Clinical Medicine
Divisions:College of Science > School of Life Sciences
ID Code:28387
Deposited On:30 Jul 2018 08:35

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