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Scientific article
English

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

Published inClinical and vaccine immunology, vol. 19, no. 11, p. 1751-1757
Publication date2012
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
  • Adolescent
  • CD4 Lymphocyte Count
  • Child
  • Child, Preschool
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • HIV Infections/immunology
  • Hepatitis A/prevention & control
  • Hepatitis A Antibodies/blood
  • Hepatitis A Vaccines/administration & dosage/immunology
  • Humans
  • Immunoglobulin G/blood
  • Male
  • Prospective Studies
  • Switzerland
  • Vaccination/methods
  • Young Adult
Citation (ISO format)
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. 1751–1757. doi: 10.1128/CVI.00264-12
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Article (Published version)
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ISSN of the journal1556-679X
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