Limited duration of vaccine poliovirus and other enterovirus excretion among human immunodeficiency virus infected children in Kenya

Abstract

BackgroundImmunodeficient persons with persistent vaccine-related poliovirus infection may serve as a potential reservoir for reintroduction of polioviruses after wild poliovirus eradication, posing a risk of their further circulation in inadequately immunized populations.MethodsTo estimate the potential for vaccine-related poliovirus persistence among HIV-infected persons, we studied poliovirus excretion following vaccination among children at an orphanage in Kenya. For 12 months after national immunization days, we collected serial stool specimens from orphanage residents aged <5 years at enrollment and recorded their HIV status and demographic, clinical, immunological, and immunization data. To detect and characterize isolated polioviruses and non-polio enteroviruses (NPEV), we used viral culture, typing and intratypic differentiation of isolates by PCR, ELISA, and nucleic acid sequencing. Long-term persistence was defined as shedding for ≥ 6 months.ResultsTwenty-four children (15 HIV-infected, 9 HIV-uninfected) were enrolled, and 255 specimens (170 from HIV-infected, 85 from HIV-uninfected) were collected. All HIV-infected children had mildly or moderately symptomatic HIV-disease and moderate-to-severe immunosuppression. Fifteen participants shed vaccine-related polioviruses, and 22 shed NPEV at some point during the study period. Of 46 poliovirus-positive specimens, 31 were from HIV-infected, and 15 from HIV-uninfected children. No participant shed polioviruses for ≥ 6 months. Genomic sequencing of poliovirus isolates did not reveal any genetic evidence of long-term shedding. There was no long-term shedding of NPEV.ConclusionThe results indicate that mildly to moderately symptomatic HIV-infected children retain the ability to clear enteroviruses, including vaccine-related poliovirus. Larger studies are needed to confirm and generalize these findings.

Complete Genome Sequence of an Enterovirus 80 Strain Isolated in China

“…Its prototype strain CA67-10387 was isolated in the United States in 1967. Subsequently, several other EV80 strains were isolated from acute flaccid paralysis (AFP) cases or healthy persons in Oman, Kenya, and India (1,6). Until now, only one complete genome sequence of EV80 (the prototype strain) has been available.…”

Isolation of poliovirus shedding following vaccination in children with antibody deficiency disorders

“…Patients with both primary [11][12][13] and secondary immunodeficiency disorders have been proved to excrete the virus in a prolonged manner [14][15][16].…”

Hand-foot-and-mouth disease caused by coxsackievirus A6 in a patient infected with HIV

“…6 However, this prolonged shedding or increased disease severity has not been noticed in patients infected with HIV. 7,8 A wide spectrum of disease is associated with enteroviruses, which can be mild to severe in nature. Some of the diseases associated with enteroviruses include meningitis, encephalitis, common cold, bronchiolitis, conjunctivitis, myocarditis, hepatitis and HFMD.…”