Avaliação da resposta humoral à vacina pneumocócica 7-valente em crianças com Aids

Abstract

OBJECTIVE:Invasive pneumococcal disease is a major cause of death in HIV-infected children. The objective of the study was to assess the quantitative antibody response to the seven pneumococcal serotypes of heptavalent pneumococcal conjugate vaccine in a group of HIV-infected children. METHODS:Study comprising 40 HIV-infected children aged between 2 and 9 years followed up in a specialized outpatient clinic in São Paulo, Brazil, between 2002 and 2003. Enzyme immunoassay (ELISA) was used to measure IgG antibody titers against pneumococcus capsule. Antibodies were measured immediately before and 1 month after the second dose of the vaccine. Two response criteria were used: IgG titers ≥1.3 μg/mL in the postimmunization serology and an increase of at least 4-fold in post-compared to pre-immunization serology. RESULTS:For the first criterion (≥1.3 μg/mL), 26 (65%) children had serological response to the vaccine, 12 (30%) showed post-immunization IgG titers of at least 1.3 μg/mL for all seven serotypes studied. For the second criterion studied (≥4-fold increase in post-compared to pre-immunization titers for four serotypes or more), serological response was seen in 15 (37.5%) children. CONCLUSIONS:Overall response to the heptavalent pneumococcal conjugate vaccine was adequate, showing a statistically signifi cant increase in the postimmunization geometric mean titers for the seven serotypes studied.

Impact of Pneumococcal Conjugate Vaccine Administration in Pediatric Older Age Groups in Low and Middle Income Countries: A Systematic Review

“…Characteristics of included studies are listed ( Table 1 ). Eight of the studies were conducted in low income countries [ 17 – 20 , 22 – 25 ], two in lower middle income countries [ 26 – 27 ], six in upper middle income countries [ 15 , 16 , 21 , 28 – 30 ], and two in high income countries [ 31 , 32 ], though they were classified as upper middle income countries at the time of the study. These studies were published between 2008 and 2014, with three presented as abstracts at the ISPPD [ 15 , 23 , 25 ].…”

“…These studies were published between 2008 and 2014, with three presented as abstracts at the ISPPD [ 15 , 23 , 25 ]. Eight studies report on 1 dose of PCV catch up [ 15 – 21 , 30 ] and eight report on 2 doses of PCV catch up [ 23 – 28 , 31 , 32 ], with two reporting both one and two dose extended age regimens [ 22 , 29 ]. Nine studies were from Africa [ 17 – 20 , 22 – 25 , 27 ] , seven from South America [ 15 , 16 , 21 , 28 , 30 – 32 ], and two from Asia [ 26 , 29 ].…”

“…Eight studies report on 1 dose of PCV catch up [ 15 – 21 , 30 ] and eight report on 2 doses of PCV catch up [ 23 – 28 , 31 , 32 ], with two reporting both one and two dose extended age regimens [ 22 , 29 ]. Nine studies were from Africa [ 17 – 20 , 22 – 25 , 27 ] , seven from South America [ 15 , 16 , 21 , 28 , 30 – 32 ], and two from Asia [ 26 , 29 ]. Eight examined PCV 7[ 17 – 21 , 28 – 29 , 31 ], nine examined PCV 10 [ 15 , 16 , 22 – 24 , 26 , 27 , 30 , 32 ], and one examined PCV 13 [ 25 ].…”

“…Nine studies were from Africa [ 17 – 20 , 22 – 25 , 27 ] , seven from South America [ 15 , 16 , 21 , 28 , 30 – 32 ], and two from Asia [ 26 , 29 ]. Eight examined PCV 7[ 17 – 21 , 28 – 29 , 31 ], nine examined PCV 10 [ 15 , 16 , 22 – 24 , 26 , 27 , 30 , 32 ], and one examined PCV 13 [ 25 ]. Three reported on disease incidence (though two report on the same data and are combined)[ 15 , 16 , 31 ], six reported on nasopharyngeal carriage [ 17 , 19 , 20 , 24 , 25 , 30 ], and nine on immune response [ 18 , 21 – 23 , 26 – 29 , 32 ] ( Table 1 ).…”

“…The ≥0.35μg/ml thresholds and ≥0.2μg/ml threshold have been reported together when the latter threshold is tested with a 22F polysaccharide inhibition ELISA, due to the improved specificity [ 33 ]. The ≥1.3μg/ml threshold and ≥4-fold increase in titres were selected by one study as surrogate markers for immune response for immunosuppressed children [ 28 ]. An immune response threshold over ≥5μg/ml was selected as a measure of carriage protection [ 18 ].…”