Centre for Vaccines and Immunology, National Institute for Communicable Diseases, a division of the National Health Laboratory Service, Johannesburg, South Africa.
Department of Health Sciences, University of Johannesburg, Johannesburg, South Africa.
PLoS One. 2019 Apr 19;14(4):e0215079. doi: 10.1371/journal.pone.0215079. eCollection 2019.
The prevalence of HIV infection in South African pregnant women has been approximately 30% over the past decade; however, there has been a steady decline in mother-to-child transmission of HIV from 8% in 2008 to <2% in 2015. We evaluated the immunogenicity of live-attenuated trivalent oral polio vaccine (OPV) following the primary vaccination series (doses at birth, 6, 10 and 14 weeks of age) in HIV-exposed uninfected (HEU), HIV-infected infants initiated on early anti-retroviral treatment (HIV+/ART+), HIV-infected infants on deferred ART (HIV+/ART-) and HIV-unexposed infants (HU) as the referent group.
Serum polio neutralization antibody titres were evaluated to serotype-1, serotype-2 and serotype-3 at 6, 10 and 18 weeks of age. Antibody titres ≥8 were considered seropositive and sero-protective.
At 18 weeks of age, following the complete primary series of four OPV doses, no differences in GMTs, percentage of infants with sero-protective titres and median fold change in antibody titre (18 weeks vs 6 weeks) were observed in HEU infants (n = 114) and HIV+/ART+ infants (n = 162) compared to HU infants (n = 104) for the three polio serotypes. However, comparing HIV+/ART- infants (n = 70) to HU infants at 18 weeks of age, we observed significantly lower GMTs for serotype-1 (p = 0.022), serotype-2 (p<0.001) and serotype-3 (p<0.001), significantly lower percentages of infants with sero-protective titres for the three serotypes (p<0.001), and significantly lower median fold change in antibody titre for serotype-1 (p = 0.048), serotype-2 (p = 0.003) and serotype-3 (p = 0.008).
Delaying initiation of ART in HIV-infected infants was associated with an attenuated immune response to OPV following a four-dose primary series of vaccines, whereas immune responses to OPV in HIV-infected children initiated on ART early in infancy and HEU children were similar to HU infants.
在过去十年中，南非孕妇的 HIV 感染率约为 30%；然而，母婴传播 HIV 的比例从 2008 年的 8%稳步下降到 2015 年的<2%。我们评估了在 HIV 暴露但未感染（HEU）、开始早期抗逆转录病毒治疗（HIV+/ART+）的 HIV 感染婴儿、延迟 ART 的 HIV 感染婴儿（HIV+/ART-）和 HIV 未暴露婴儿（HU）中，经口服减毒三价脊灰疫苗（OPV）初次免疫系列（出生时、6、10 和 14 周龄的剂量）后，活疫苗的免疫原性。
在 6、10 和 18 周龄时，评估血清脊灰中和抗体滴度针对血清型 1、2 和 3。抗体滴度≥8 被认为是血清阳性和血清保护。
在 18 周龄时，在完成四剂 OPV 初次免疫系列后，与 HU 婴儿（n = 104）相比，HEU 婴儿（n = 114）和 HIV+/ART+婴儿（n = 162）的三种脊灰血清型的 GMT、具有血清保护滴度的婴儿百分比和抗体滴度的中位数倍数变化（18 周与 6 周）无差异。然而，与 HU 婴儿相比，在 18 周龄时，与 HU 婴儿相比，HIV+/ART-婴儿（n = 70）观察到血清型 1（p = 0.022）、血清型 2（p<0.001）和血清型 3（p<0.001）的 GMT 显著降低，三种血清型的具有血清保护滴度的婴儿百分比显著降低（p<0.001），血清型 1（p = 0.048）、血清型 2（p = 0.003）和血清型 3（p = 0.008）的抗体滴度中位数倍数变化显著降低。
延迟 HIV 感染婴儿的 ART 开始与四剂初次疫苗系列后 OPV 的免疫反应减弱相关，而在婴儿早期开始 ART 的 HIV 感染儿童和 HEU 儿童对 OPV 的免疫反应与 HU 婴儿相似。
