HIV 感染儿童、青少年和青年人群中脑膜炎奈瑟球菌 C 群结合疫苗的免疫原性。

Immunogenicity of a meningococcal serogroup C conjugate vaccine in HIV-infected children, adolescents, and young adults.

机构信息

Centro de Referência e Treinamento em DST/Aids, Programa Estadual São Paulo, São Paulo, Brazil.

出版信息

Vaccine. 2012 Aug 10;30(37):5482-6. doi: 10.1016/j.vaccine.2012.06.069. Epub 2012 Jul 6.

Abstract

Children and adolescents infected with HIV typically have a lower response to immunization than do those in the general population. In most developed countries, meningococcal serogroup C conjugate vaccine is one of the recommended vaccines for such individuals. However, there have been no studies evaluating the antibody response to this vaccine in HIV-infected children, adolescents or young adults. In this study, we evaluated that response using serum bactericidal antibody (SBA) and enzyme-linked immunosorbent assay, comparing HIV-infected with non-HIV-infected patients, as well as analysing the occurrence of side effects. In non-responders, we assessed the antibody response to revaccination. This clinical trial involved 92 patients between 10 and 20 years of age: 43 HIV-infected patients (HIV+ group) and 49 non-HIV-infected patients (HIV- group). After one dose of the vaccine, 72.1% of the HIV+ group patients and 100% of the HIV- group patients were considered protected. Of the HIV+ group patients who received a second dose of the vaccine, only 40% acquired protection. Overall, 81.4% of the HIV+ group patients acquired protection (after one or two doses of the vaccine). Side effects occurred in 16.3% and 44% of the HIV+ group and HIV- group patients, respectively. Therefore, the meningococcal serogroup C conjugate vaccine proved to be safe and effective for use in HIV-infected children, adolescents, and young adults, although their antibody response was weaker than that shown by non-HIV-infected patients. This indicates the need to discuss changes to the immunization schedule for children, adolescents, and young adults infected with HIV, in order to ensure more effective protection against meningococcal disease.

摘要

儿童和青少年艾滋病毒感染者对免疫接种的反应通常低于一般人群。在大多数发达国家,脑膜炎球菌 C 群结合疫苗是推荐给此类人群的疫苗之一。然而,目前还没有研究评估该疫苗在艾滋病毒感染儿童、青少年或年轻人中的抗体反应。在这项研究中,我们使用血清杀菌抗体(SBA)和酶联免疫吸附试验评估了这种反应,将艾滋病毒感染患者与非艾滋病毒感染患者进行了比较,并分析了副作用的发生情况。在无反应者中,我们评估了对再接种疫苗的抗体反应。这项临床试验涉及 92 名 10 至 20 岁的患者:43 名艾滋病毒感染患者(HIV+组)和 49 名非艾滋病毒感染患者(HIV-组)。接种一剂疫苗后,72.1%的 HIV+组患者和 100%的 HIV-组患者被认为具有保护作用。在接受第二剂疫苗的 HIV+组患者中,只有 40%获得了保护。总体而言,81.4%的 HIV+组患者获得了保护(接种一剂或两剂疫苗后)。HIV+组和 HIV-组患者的副作用发生率分别为 16.3%和 44%。因此,脑膜炎球菌 C 群结合疫苗在 HIV 感染的儿童、青少年和年轻人中证明是安全有效的,尽管他们的抗体反应比非 HIV 感染患者弱。这表明需要讨论改变 HIV 感染儿童、青少年和年轻人的免疫接种计划,以确保更有效地预防脑膜炎球菌病。

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