Article: article from journal or magazin.
Determinants of hepatitis A vaccine immunity in a cohort of human immunodeficiency virus-infected children living in Switzerland.
Clinical and Vaccine Immunology
Swiss Mother, Child HIV Cohort Study of Switzerland
Aebi C., Battegay M., Bernasconi E., Böni J., Brazzola P., Bucher HC., Bürgisser P., Calmy A., Cattacin S., Cavassini M., Cheseaux JJ., Drack G., Dubs R., Egger M., Elzi L., Fischer M., Flepp M., Fontana A., Francioli P., Furrer H., Fux CA., Gayet-Ageron A., Gerber S., Gorgievski M., Grawe C., Günthard HF., Gyr T., Hirsch HH., Hirschel B., Hösli I., Kaiser L., Kahlert C., Karrer U., Kind C., Klimkait T., Ledergerber B., Martinetti G., Müller N., Nadal D., Paccaud F., Pantaleo G., Raio L., Rauch A., Regenass S., Rickenbach M., Rudin C., Schmid P., Schultze D., Schöni-Affolter F., Schüpbach J., Speck R., de Tejada BM. , Taffé P., Telenti A., Trkola A., Vernazza P., Weber R., Wyler CA., Yerly S.
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
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.
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, Hepatitis A Vaccines/immunology, Humans, Immunoglobulin G/blood, Male, Prospective Studies, Switzerland, Vaccination/methods, Young Adult
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