Antibody responses against vaccine-preventable infectious diseases in HIV-exposed and unexposed Malawian infants

Author:

Baroncelli Silvia1,Galluzzo Clementina Maria1,Orlando Stefano2,Pirillo Maria Franca1,Luhanga Richard3,Mphwere Robert3,Kavalo Thom3,Amici Roberta1,Floridia Marco1,Andreotti Mauro1,Ciccacci Fausto4,Scarcella Paola2,Marazzi Maria Cristina3,Giuliano Marina1

Affiliation:

1. Istituto Superiore di Sanità

2. University of Rome Tor Vergata

3. DREAM Program, Community of S. Egidio

4. Saint Camillus International University of Health and Medical Sciences

Abstract

Abstract Background The evaluation of immunological status with respect to vaccine-preventable infectious diseases allows to identify populations with suboptimal protection. HIV-exposed infants, even if not infected with HIV, have higher morbidity and mortality in comparison to their unexposed counterparts, and even if the underlying mechanisms have not been clearly elucidated, dysfunctional immune responses might be involved. The aim of this study was to evaluate post-vaccination immune responses in two groups of infants (HIV-exposed and HIV-unexposed) living in the area of Blantyre, Malawi, measuring IgG levels against Haemophilus Influenzae type B (HiB), Hepatitis B (HBV), and Streptococcus pneumoniae (PCP). Methods Sixty-two infants, 49 HIV-exposed, uninfected (HEU), born to women living with HIV, and 13 HIV-unexposed, uninfected (HUU), born to HIV-negative mothers, were included in the study. The infants were visited monthly, from birth to 12 months, and blood samples were collected at 6 months. Anti-HiB, -HBV and -PCP vaccines are administered in Malawi at 6, 10, and 14 weeks of life. The antibody responses to the vaccines were determined by ELISA tests. Results The geometric mean concentrations (GMCs) of anti-HiB, anti-HBs and anti-PCP antibodies were not different between the two groups. The proportion of infants with protective levels (> 0.15 mg/l) versus HiB was lower (although not significantly) in HEU in comparison to HUU infants (81.6% vs 100%, p = 0.095). There was no significant difference between the two groups in the proportion of infants with protective antibody levels against HBV or PCP, although this proportion was lower than expected in both groups, varying from 81.6–84%. Overall, only 61.3% of the infants showed protective levels against all three vaccine antigens. Conclusions The humoral response after vaccination was similar in HEU and HUU infants. A disturbingly high proportion of infants without protective antibody levels against HBV and PCP in both groups of infants and against HiB in HEU infants was observed.

Publisher

Research Square Platform LLC

Reference37 articles.

1. The World data Bank. 2022 Prevalence of HIV, total (% of population ages 15–49) - Malawi. https://data.worldbank.org/indicator/SH.DYN.AIDS.ZS?locations=MW Accessed 15 Sept 2022.

2. UNICEF Data. Monitoring the situation of children and women 2021. https://data.unicef.org/topic/child-survival/under-five-mortality/ Accessed 22 Sept 2022.

3. UNAIDS - Malawi Country factsheet. 2020. https://www.unaids.org/en/regionscountries/countries/malawi Accessed 18 Oct 18 2022.

4. World Health Organization Regional Office for Africa 2014. T Implementation of Option B + for Prevention of Mother-To-Child Transmission of HIV: Malawi experience. https://www.afro.who.int/sites/default/files/2017-07/implementation-of-option-b%2B-for-prevention-of-mother-to-child-transmission.pdf Accessed 15 Oct 2022.

5. Risks and benefits of lifelong antiretroviral treatment for pregnant and breastfeeding women: A review of the evidence for the Option B + approach;Ahmed S;Curr Opin HIV AIDS,2013

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