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Determinants of hepatitis a vaccine immunity in a cohort of human immunodeficiency virus-infected children living in Switzerland

Pierre Alex Crisinel, Klara Maria Posfay-Barbe, Christoph Aebi, Jean-Jacques Cheseaux, Christian R. Kahlert, Christoph Rudin, David Nadal, Claire-Anne Siegrist & Swiss Mother And Child HIV Cohort Study Of Switzerland (MoCHiV)

abstract Vaccination in HIV-infected children is often less effective than in healthy children. The goal of this study was to assess vaccine responses to hepatitis A virus (HAV) in HIV-infected children. Children of the Swiss Mother and Child HIV Cohort Study (MoCHiV) were enrolled prospectively. Recommendations for initial, catch-up, and additional HAV immunizations were based upon baseline antibody concentrations and vaccine history. HAV IgG was assessed by enzyme-linked immunosorbent assay (ELISA) with a protective cutoff value defined as ≥10 mIU/ml. Eighty-seven patients were included (median age, 11 years; range, 3.4 to 21.2 years). Forty-two patients were seropositive (48.3%) for HAV. Among 45 (51.7%) seronegative patients, 36 had not received any HAV vaccine dose and were considered naïve. Vaccine responses were assessed after the first dose in 29/35 naïve patients and after the second dose in 33/39 children (25 initially naïve patients, 4 seronegative patients, and 4 seropositive patients that had already received 1 dose of vaccine). Seroconversion was 86% after 1 dose and 97% after 2 doses, with a geometric mean concentration of 962 mIU/ml after the second dose. A baseline CD4(+) T cell count below 750 cells/μl significantly reduced the post-2nd-dose response (P = 0.005). Despite a high rate of seroconversion, patients with CD4(+) T cell counts of <750/μl had lower anti-HAV antibody concentrations. This may translate into a shorter protection time. Hence, monitoring humoral immunity may be necessary to provide supplementary doses as needed.
   
citation Crisinel P A, Posfay-Barbe K M, Aebi C, Cheseaux J J, Kahlert C R, Rudin C, Nadal D, Siegrist C A, Swiss Mother and Child HIV Cohort Study of Switzerland (MoCHiV) . Determinants of hepatitis a vaccine immunity in a cohort of human immunodeficiency virus-infected children living in Switzerland. Clin Vaccine Immunol 2012; 19:1751-7.
   
type journal paper/review (English)
date of publishing 29-08-2012
journal title Clin Vaccine Immunol (19/11)
ISSN electronic 1556-679X
pages 1751-7
PubMed 22933400
DOI 10.1128/CVI.00264-12