Immunogenicity and safety of two doses of catch-up immunization with Haemophilus influenzae type b conjugate vaccine in Indian children living with HIV

Bikas K. Arya, Sangeeta Das Bhattacharya, Catherine Sutcliffe, Malay K. Saha, Subhasish Bhattacharyya, Swapan Kumar Niyogi, William J Moss, Samiran Panda, Ranjan Saurav Das, Mausom Mallick, Sutapa Mandal

Research output: Contribution to journalArticle

Abstract

Background: Children living with HIV are at increased risk of disease from Haemophilus influenzae type b (Hib). Data are limited on the immunogenicity of a two-dose, catch-up schedule for Hib conjugate vaccine (HibCV) among HIV-infected children accessing antiretroviral therapy (ART) late. Objectives: The objectives of the study were to: (1) evaluate baseline immunity to Hib and the immunogenicity and safety of two doses of HibCV among HIV-infected Indian children; and (2) document the threshold antibody level required to prevent Hib colonization among HIV-infected children following immunization. Methods: We conducted a prospective cohort study among HIV-infected children 2-15 years of age and HIV-uninfected children 2-5 years of age. HIV-infected children received two doses of HibCV and uninfected children received one. Serum anti-Hib PRP IgG antibodies were measured at baseline and two months after immunization in the HIV-infected children. Nasopharyngeal (NP) swabs were collected at baseline and follow-up. Results: 125 HIV-infected and 44 uninfected children participated. 40% of HIV-infected children were receiving ART and 26% had a viral load >100,000 copies/mL. The geometric mean concentration of serum anti-Hib PRP antibody increased from 0.25 μg/mL at baseline to 2.65 μg/mL after two doses of HibCV, representing a 10.6-fold increase (p <0.0001). 76% percent of HIV-infected children mounted an immune response. Moderate or severe immune suppression, trimethoprim/sulfamethoxazole prophylaxis, and lower baseline antibody levels were associated with lower post-vaccine serum anti-Hib PRP IgG antibodies. A serum anti-Hib PRP IgG antibody level ≥3.3 μg/mL was protective against Hib NP colonization. There were no differences in adverse events between HIV-infected and uninfected children. Conclusion: Including a catch-up immunization schedule for older HIV infected children in countries introducing Hib vaccines is important. Older HIV-infected children with delayed access to ART and without suppressed viral loads mounted an adequate immune response following two doses of HibCV.

Original languageEnglish (US)
Pages (from-to)2267-2274
Number of pages8
JournalVaccine
Volume34
Issue number19
DOIs
StatePublished - Apr 27 2016

Keywords

  • Anti-Hib PRP IgG
  • Conjugate vaccines
  • Haemophilus influenzae type b
  • HIV
  • Immune response
  • Nasopharyngeal carriage

ASJC Scopus subject areas

  • Immunology and Microbiology(all)
  • Infectious Diseases
  • Public Health, Environmental and Occupational Health
  • veterinary(all)
  • Molecular Medicine

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  • Cite this

    Arya, B. K., Bhattacharya, S. D., Sutcliffe, C., Saha, M. K., Bhattacharyya, S., Niyogi, S. K., Moss, W. J., Panda, S., Das, R. S., Mallick, M., & Mandal, S. (2016). Immunogenicity and safety of two doses of catch-up immunization with Haemophilus influenzae type b conjugate vaccine in Indian children living with HIV. Vaccine, 34(19), 2267-2274. https://doi.org/10.1016/j.vaccine.2016.03.012