INTRODUCTION: In addition to reducing Haemophilus influenzae type b (Hib) disease in vaccinated individuals, the Hib conjugate vaccine (HibCV) has indirect effects; it reduces Hib disease in unvaccinated individuals by decreasing carriage. HIV infected children are at increased risk for Hib disease and live in families where multiple members may have HIV. OBJECTIVE: To look at the impact of 2 doses of the HibCV on nasopharyngeal carriage of Hib in HIV infected Indian children (2-15 years) and the indirect impact on carriage in their parents. METHODS: This prospective cohort study was conducted in HIV infected and uninfected families. Nasopharyngeal swabs were collected from children and parents before and after vaccination. HIV infected children ages 2-15 years got two doses of HibCV and were followed up for 20 months. Uninfected children age 2-5 years got 1 dose of HibCV as catch-up. RESULTS: 123 HIV infected and 44 HIV uninfected children participated. Baseline colonization in HIV infected children was13.8% and dropped to 1.8% (p=0.002) at 20 months. Baseline carriage in HIV uninfected children was 4.5%, and dropped to 2.3% after vaccination (p=0.3). HIV infected parents had 12.3 times increased risk of Hib carriage if their child was colonized (p=0.04) and 9.3 times increased risk if their child had persistent colonization post vaccine (p=0.05). No parent of HIV uninfected children had Hib colonization at any point. Pneumococcal colonization was associated with increased Hib colonization. CONCLUSION: Making the HibCV available to HIV infected children could interrupt Hib carriage in high risk families.
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Infectious Diseases
- Microbiology (medical)