Zin Annachiara, Barbieri Elisa, Brigadoi Giulia, Berlese Andrea, Chiusaroli Lorenzo, Mengato Daniele, Francavilla Andrea, Giaquinto Carlo, Donà Daniele, Rampon Osvalda
Division of Pediatric Infectious Diseases, Department of Women's and Children's Health, University of Padua, 35128 Padua, Italy.
Hospital Pharmacy Department, University Hospital of Padua, 35128 Padua, Italy.
Vaccines (Basel). 2025 Aug 16;13(8):871. doi: 10.3390/vaccines13080871.
Despite virological suppression through antiretroviral therapy (ART), people living with HIV (PLHIV) may exhibit inadequate immune responses to vaccination, placing them at continued risk for preventable infectious diseases. Evidence regarding the durability of vaccine-induced immunity in PLHIV with vertically acquired infection remains limited.
We conducted a cross-sectional observational study to evaluate humoral immunity to routine childhood vaccines in a cohort of PLHIV with perinatally acquired infection. Antibody titers against diphtheria, tetanus, measles, mumps, rubella, varicella, and hepatitis B (HBV) were retrospectively assessed via serological testing and review of medical records. Seroprotection rates were analyzed at predefined intervals following the completion of the primary immunization schedule. Multivariate analysis was used to explore potential predictors of long-term immune response.
A total of 85 individuals were included. Two years after completing the primary vaccination series, seroprotection rates were as follows: diphtheria 71%, tetanus 79%, measles 79%, mumps 67%, rubella 87%, and varicella 54%. Five years post-vaccination, 50-70% of participants maintained protective antibody levels, declining further to 50-58% after ten years. By twenty years, protective immunity dropped below 30% for all antigens except rubella (47%). HBV vaccine responses were notably poor, with only 60%, 37%, 24%, and 7.5% retaining protective anti-HBs titers at 2, 5, 10, and 20 years post-immunization, respectively. Time elapsed since vaccination was the sole significant predictor of seroprotection across all vaccines.
In this cohort of vertically infected PLHIV, vaccine-induced immunity was suboptimal and declined markedly over time compared to the general population. These findings highlight the need for tailored immunization strategies, including timely boosters and regular serological monitoring, to maintain long-term protection in this high-risk group.
尽管通过抗逆转录病毒疗法（ART）实现了病毒学抑制，但人类免疫缺陷病毒感染者（PLHIV）对疫苗接种可能表现出免疫反应不足，使他们仍面临可预防传染病的持续风险。关于垂直感染的PLHIV中疫苗诱导免疫的持久性的证据仍然有限。
我们进行了一项横断面观察性研究，以评估一组围产期感染的PLHIV对常规儿童疫苗的体液免疫。通过血清学检测和病历审查，回顾性评估了针对白喉、破伤风、麻疹、腮腺炎、风疹、水痘和乙型肝炎（HBV）的抗体滴度。在完成基础免疫程序后的预定时间间隔分析血清保护率。采用多变量分析来探索长期免疫反应的潜在预测因素。
共纳入85名个体。完成基础疫苗接种系列两年后，血清保护率如下：白喉71%，破伤风79%，麻疹79%，腮腺炎67%，风疹87%，水痘54%。接种疫苗五年后，50 - 70%的参与者维持保护性抗体水平，十年后进一步降至50 - 58%。到二十年时，除风疹（47%）外，所有抗原的保护性免疫均降至30%以下。HBV疫苗反应明显较差，免疫后2年、5年、10年和20年分别仅有60%、37%、24%和7.5%的人保持保护性抗-HBs滴度。接种疫苗后的时间是所有疫苗血清保护的唯一显著预测因素。
在这组垂直感染的PLHIV中，疫苗诱导的免疫效果欠佳，与一般人群相比，随时间显著下降。这些发现凸显了需要制定针对性的免疫策略，包括及时加强免疫和定期血清学监测，以在这一高危人群中维持长期保护。
