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

Kahlert, Christian
Rudin, Christoph
Nadal, David
Published in Clinical and vaccine immunology. 2012, vol. 19, no. 11, p. 1751-7
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.
Keywords AdolescentCD4 Lymphocyte CountChildChild, PreschoolEnzyme-Linked Immunosorbent AssayFemaleHIV Infections/immunologyHepatitis A/prevention & controlHepatitis A Antibodies/bloodHepatitis A Vaccines/administration & dosage/immunologyHumansImmunoglobulin G/bloodMaleProspective StudiesSwitzerlandVaccination/methodsYoung Adult
PMID: 22933400
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Research groups Centre de Vaccinologie et d'Immunologie néonatale (177)
Recherche en infectiologie pédiatrique et en pédiatrie générale (853)
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CRISINEL, Pierre-Alex et al. Determinants of hepatitis A vaccine immunity in a cohort of human immunodeficiency virus-infected children living in Switzerland. In: Clinical and vaccine immunology, 2012, vol. 19, n° 11, p. 1751-7. doi: 10.1128/CVI.00264-12 https://archive-ouverte.unige.ch/unige:31579

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Deposited on : 2013-12-03

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