Immunological Abnormalities in Pediatric Aids

Español, Teresa; Garcia, Xochella; Caragol, Isabel; Sauleda, Sílvia; Muntane, C.

doi:10.3109/08820139109050790

Cited by 5 publications

(4 citation statements)

References 9 publications

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“…OPV is given to children regardless of HIV status at 3, 4, 5, and 18 months of age per the Zimbabwean vaccination schedule. During the study period, supplementary vaccination campaigns providing additional OPV doses were held [6][7][8][9][10][11][12][13][14][15][16][17][18] Enrollment occurred between September 2008 and December 2010 at 2 community clinics in Chitungwiza. Initial inclusion criteria included age between 2 and 4 months, a birth mother with known HIV status, and plans to receive OPV according to the national schedule.…”

Section: Study Design and Populationmentioning

confidence: 99%

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Vaccine Poliovirus Shedding and Immune Response to Oral Polio Vaccine in HIV-Infected and -Uninfected Zimbabwean Infants

Troy¹,

Musingwini²,

Halpern³

et al. 2013

The Journal of Infectious Diseases

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Background. With prolonged replication, attenuated polioviruses used in oral polio vaccine (OPV) can mutate into vaccine-derived poliovirus (VDPV) and cause poliomyelitis outbreaks. Individuals with primary humoral immunodeficiencies can become chronically infected with vaccine poliovirus, allowing it to mutate into immunodeficiency-associated VDPV (iVDPV). It is unclear if children perinatally infected with the human immunodeficiency virus (HIV), who have humoral as well as cellular immunodeficiencies, might be sources of iVDPV.Methods. We conducted a prospective study collecting stool and blood samples at multiple time points from Zimbabwean infants receiving OPV according to the national schedule. Nucleic acid extracted from stool was analyzed by real-time polymerase chain reaction for OPV serotypes.Results. We analyzed 825 stool samples: 285 samples from 92 HIV-infected children and 540 from 251 HIV-uninfected children. Poliovirus shedding was similar after 0-2 OPV doses but significantly higher in the HIVinfected versus uninfected children after ≥3 OPV doses, particularly within 42 days of an OPV dose, independent of seroconversion status. HIV infection was not associated with prolonged or persistent poliovirus shedding. HIV infection was associated with significantly lower polio seroconversion rates.Conclusions. HIV infection is associated with decreased mucosal and humoral immune responses to OPV but not the prolonged viral shedding required to form iVDPV.

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Section: Study Design and Populationmentioning

confidence: 99%

“…HIV infection during the perinatal period is associated with humoral as well as cellular immunodeficiencies [9]. Children perinatally infected with HIV often have a polyclonal hypergammaglobulinemia paradoxically associated with diminished antibody responses to specific antigens [10][11][12].…”

mentioning

confidence: 99%

Vaccine Poliovirus Shedding and Immune Response to Oral Polio Vaccine in HIV-Infected and -Uninfected Zimbabwean Infants

Troy¹,

Musingwini²,

Halpern³

et al. 2013

The Journal of Infectious Diseases

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“…HIV infection during perinatal phase is correlated with humoral and cellular immunodeficiencies. It has been advanced that perinatally HIV infected children have been identified to have a polyclonal hypergammaglobulinemia paradoxically linked with reduced antibody responses to specific antigens [ 20 – 22 ]. Furthermore, individuals with certain defects of antibody production are known to be affected by chronic VDPV persistence [ 1 , 23 ], with limited insights about PV persistence among HIV+ persons.…”

Section: Introductionmentioning

confidence: 99%

Vaccine-related poliovirus shedding in trivalent polio vaccine and human immunodeficiency virus status: analysis from under five children

Hassan

Wangai

Borus³

et al. 2017

BMC Res Notes

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BackgroundPoliomyelitis is an acute viral infection caused by poliovirus and transmitted via the fecal–oral route. The causative agent is one of the three serotypes of poliovirus (serotypes 1, 2, 3) that differ slightly in capsid protein. Prolonged vaccine-related poliovirus shedding in human immunodeficiency virus (HIV) positive individuals has been linked to possible reservoir for reintroduction of polioviruses after eradication. The study therefore aimed at estimating the duration for vaccine-related poliovirus shedding among potentially and HIV-infected persons.MethodsPoliovirus excretion was studied following vaccination of children aged ≤ 59 month per human immunodeficiency virus status after national immunization days. Their medical records were reviewed to identify the child’s HIV status, demographic and immunization data. Sequential stool samples were collected at site 2nd, 4th and 8th week after trivalent oral poliovirus vaccine (tOPV) was administered. To isolate suspected polioviruses and non-polio enteroviruses, characterize poliovirus subtypes by intratypic differentiation and Sabin vaccine derived poliovirus, real time polymerase chain reaction was applied. Shedding for ≥ 24 weeks was defined as long-term persistence.ResultsThe mean age of the study population was 28.6 months, while the median age was 24 months. Of the children recruited, majority were in the 25–48 months (n = 12; 46.2%) age category. All the HIV-positive children (n = 10) had mild symptomatic HIV status and did shed vaccine-related polioviruses between weeks 2 and 4 respectively. No participant shed polioviruses for ≥ 6 weeks.ConclusionsIt was evident mildly symptomatic HIV+ children sustain the capacity to clear vaccine-related poliovirus. The oral poliovirus vaccine-2 (Sabin like) that was detected in one HIV-infected child’s stool 6 weeks after the national immunization days was predominantly non revertant. There was no evident prolonged poliovirus shedding among the participants enlisted in the present study. High powered studies are desired to further corroborate these findings.

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“…One consideration in understanding the evolution of OPV variants such as VAPP and VDPVs is the impact that pediatric infection with the human immunodeficiency virus (HIV) might have in the development of these OPV variants. In contrast to adults, children with HIV infection may manifest acquired humoral immunodeficiency and, as a result, decreased antibody responses to infections as well as to vaccines, including OPV [ 18 , 19 ]. We and others have identified decreased seroconversion to OPV among children with HIV infection, as well as OPV shedding independent of the number of administered doses of the vaccine.…”

mentioning

confidence: 99%

Pediatric HIV Infection and Decreased Prevalence of OPV Point Mutations Linked to Vaccine-associated Paralytic Poliomyelitis

Halpern

Altamirano

Maldonado

2018

Clinical Infectious Diseases

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BackgroundMutations associated with prolonged replication of the attenuated polioviruses found in oral poliovirus vaccine (OPV) can lead to vaccine-derived poliovirus (VDPV) and cause paralysis indistinguishable from that caused by wild poliovirus. In response, the World Health Organization has initiated the transition to exclusive use of inactivated poliovirus vaccine (IPV), with OPV administration in cases of outbreak. However, it is currently unclear how IPV-only vaccination, well known to provide humoral but not mucosal immunity, will impact the development of paralysis causing OPV variants. Children infected with human immunodeficiency virus (HIV) have been documented to show decreased mucosal immunity following OPV vaccination. Thus, HIV-infected children vaccinated with OPV may serve as proxy for children with IPV-only vaccination.MethodsWe conducted a prospective study of Zimbabwean infants receiving OPV as part of their routine vaccination schedule. Stool samples collected from OPV-vaccinated children serially until age 24 months were tested for OPV serotypes using a real-time polymerase chain reaction protocol that quantifies the amount of mutant OPV variants found in each sample.ResultsOut of 2130 stool samples collected from 402 infants 365 stool samples were OPV positive: 313 from 212 HIV-noninfected (HIV−) infants and 52 from 34 HIV-infected (HIV+) infants. HIV− infants showed significantly higher proportions of OPV mutants when compared to HIV+ infants.ConclusionsHIV infection is associated with a reduced proportion of OPV vaccine associated paralytic polio mutants. These results suggest that OPV administered to individuals previously vaccinated only with IPV will show decreased propensity for OPV mutations.

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Immunological Abnormalities in Pediatric Aids

Cited by 5 publications

References 9 publications

Vaccine Poliovirus Shedding and Immune Response to Oral Polio Vaccine in HIV-Infected and -Uninfected Zimbabwean Infants

Vaccine Poliovirus Shedding and Immune Response to Oral Polio Vaccine in HIV-Infected and -Uninfected Zimbabwean Infants

Vaccine-related poliovirus shedding in trivalent polio vaccine and human immunodeficiency virus status: analysis from under five children

Pediatric HIV Infection and Decreased Prevalence of OPV Point Mutations Linked to Vaccine-associated Paralytic Poliomyelitis

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