巴西里约热内卢感染和未感染艾滋病毒的儿童及青少年中脑膜炎球菌C结合疫苗的免疫原性和安全性

Immunogenicity and safety of meningococcal C conjugate vaccine in children and adolescents infected and uninfected with HIV in Rio de Janeiro, Brazil.

作者信息

Frota Ana Cristina C, Milagres Lucimar G, Harrison Lee H, Ferreira Bianca, Menna Barreto Daniela, Pereira Gisele S, Cruz Aline C, Pereira-Manfro Wania, de Oliveira Ricardo Hugo, Abreu Thalita F, Hofer Cristina B

机构信息

From the *Department of Pediatrics and †Department of Preventive Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; ‡Department of Microbiology and Immunology, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil; and §Infectious Diseases Epidemiology Research Unit, University of Pittsburgh, Pittsburgh, PA.

出版信息

Pediatr Infect Dis J. 2015 May;34(5):e113-8. doi: 10.1097/INF.0000000000000630.

DOI:10.1097/INF.0000000000000630

PMID:25876102

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4454630/

Abstract

BACKGROUND

We aimed to evaluate the Meningococcal (Neisseria meningitidis) C conjugated (MCC) vaccine seroconversion and adverse events (AEs) in HIV-infected and HIV-uninfected children and adolescents in Rio de Janeiro, Brazil.

METHODS

HIV-infected or HIV-uninfected subjects, 2-18 years old, with CD4+ T-lymphocyte cell (CD4) percentage >15%, without active infection or antibiotic use, were enrolled. All patients were evaluated before and 1-2 months after immunization for seroconversion (defined as ≥4-fold titer increase in human serum bactericidal activity) and at 20 minutes, 3 and 7 days after immunization for AEs. Factors associated with seroconversion among HIV-infected group were studied.

RESULTS

Two hundred four subjects were enrolled: 154 HIV-infected and 50 HIV-uninfected. Median age was 12 years, and 53% were female. Among the HIV-infected group, 82 (53%) had a history of at least 1 C clinical category of Centers for Diseases Control and Prevention event, and 134 (87%) were using combination antiretroviral therapy. The median nadir CD4 percentage was 13% (0-47%). Seventy-six (37.3%) experienced mild AEs. Seroconversion occurred in 46 of 154 (30%) in the HIV-infected group and in 38 of 50 (76%) in the uninfected group (P < 0.01). Factors associated with seroconversion in the HIV-infected group were as follows: never had a C clinical category event [odds ratio (OR) = 2.1, 95% confidence interval (CI): 1.0-4.4]; undetectable viral load at immunization (OR: 2.4, 95% CI: 1.1-5.2) and higher CD4 nadir/100 cells (OR: 1.1, 95% CI: 1.0-1.2).

CONCLUSION

MCC vaccine should be administered to HIV-infected children and adolescents after maximum immunologic and virologic benefits have been achieved with combination antiretroviral therapy. Our data suggest that a single dose of MCC vaccine is insufficient for HIV-infected individuals 2-18 years of age.

摘要

背景

我们旨在评估巴西里约热内卢感染HIV和未感染HIV的儿童及青少年中脑膜炎球菌（脑膜炎奈瑟菌）C结合疫苗（MCC）的血清转化情况及不良事件（AE）。

方法

纳入年龄在2至18岁、CD4 + T淋巴细胞（CD4）百分比> 15%、无活动性感染或未使用抗生素的HIV感染或未感染HIV的受试者。所有患者在免疫前及免疫后1至2个月评估血清转化情况（定义为人类血清杀菌活性滴度增加≥4倍），并在免疫后20分钟、3天和7天评估不良事件。研究了HIV感染组中与血清转化相关的因素。

结果

共纳入204名受试者：154名HIV感染者和50名未感染HIV者。中位年龄为12岁，53%为女性。在HIV感染组中，82例（53%）有至少1次美国疾病控制与预防中心C类临床事件史，134例（87%）正在接受抗逆转录病毒联合治疗。CD4最低点百分比中位数为13%（0 - 47%）。76例（37.3%）出现轻度不良事件。HIV感染组154例中有46例（30%）发生血清转化，未感染组50例中有38例（76%）发生血清转化（P < 0.01）。HIV感染组中与血清转化相关的因素如下：从未发生过C类临床事件[比值比（OR）= 2.1，95%置信区间（CI）：1.0 - 4.4]；免疫时病毒载量不可检测（OR：2.4，95% CI：1.1 - 5.2）以及CD4最低点/100细胞数较高（OR：1.1，95% CI：1.0 - 1.2）。