TY - JOUR
T1 - Immunogenicity of three Haemophilus influenzae type b protein conjugate vaccines in HIV seropositive adults and analysis of predictors of vaccine response
AU - Dockrell, David H.
AU - Poland, Gregory A.
AU - Steckelberg, James M.
AU - Wollan, Peter C.
AU - Strickland, Scott R.
AU - Pomeroy, Claire
N1 - Funding Information:
The authors wish to thank the medical staff and patients at the three centers who participated in the study. This study would not have been possible without their cooperation. This study was supported by funding provided by the Mayo Clinic and Foundation. Finally, the authors wish to acknowledge Henry A. Homburger, M.D. and Jerry A. Katzmann, Ph.D. (Mayo Clinic) for assistance in performing the IgG, IgG1 and IgG2 assays, and Maurice W. Harmon, Ph.D. and Michael J. Bybel, B.Sc. (both of Pasteur Merieux Connaught Laboratories, USA) for assistance in performing the anti-PRP Farr assays. In addition, we thank Gail Sim for her secretarial support.
PY - 1999/7/16
Y1 - 1999/7/16
N2 - HIV-seropositive adults may be at increased risk of infection due to Haemophilus influenzae type b (Hib) as compared with HIV-seronegative adults. Protein conjugate vaccines have been demonstrated to induce protective levels of antibodies against Hib in immunocompetent infants and also in HIV- seropositive infants. In this study we determined the immunogenicity of three protein conjugate Hib vaccines (PRP-D, HbOC, HbNOMP) in 135 HIV-seropositive adults who received one dose of Hib vaccine. Anti-polyribosylribitol phosphate (PRP) antibodies were measured at 0, 1, 3 and 12 months postimmunization by the Farr method. We demonstrate that all three vaccines are highly immunogenic and result in protective (> 1.0 μg/ml) levels of antibody. Overall the anti-PRP antibody level was > 1.0 μg/ml in 26% of patients preimmunization, 91% at both 1 and 3 months, and 79% at 12 months postvaccination. Comparison of responses to the three vaccines over time demonstrated differences in the mean geometric anti-PRP antibody level at 1 month (p = 0.03) and the 12 month time points (p = 0.03) with lower geometric mean levels in the HbNOMP group, though baseline differences in groups limit the interpretation of these findings. In a univariate analysis of baseline characteristics which predicted poor vaccine response, low total IgG2 levels preimmunization predicted a poor antibody response at 1 month (p < 0.01) and at 12 months (p=0.05), while low CD4 T-cell count predicted poor response at 12 months (p < 0.01). We conclude that all three US licensed protein conjugate Hib vaccines are immunogenic in HIV-seropositive adults, and that baseline CD4 T-cell count and IgG2 levels predict the likelihood of antibody response to vaccine.
AB - HIV-seropositive adults may be at increased risk of infection due to Haemophilus influenzae type b (Hib) as compared with HIV-seronegative adults. Protein conjugate vaccines have been demonstrated to induce protective levels of antibodies against Hib in immunocompetent infants and also in HIV- seropositive infants. In this study we determined the immunogenicity of three protein conjugate Hib vaccines (PRP-D, HbOC, HbNOMP) in 135 HIV-seropositive adults who received one dose of Hib vaccine. Anti-polyribosylribitol phosphate (PRP) antibodies were measured at 0, 1, 3 and 12 months postimmunization by the Farr method. We demonstrate that all three vaccines are highly immunogenic and result in protective (> 1.0 μg/ml) levels of antibody. Overall the anti-PRP antibody level was > 1.0 μg/ml in 26% of patients preimmunization, 91% at both 1 and 3 months, and 79% at 12 months postvaccination. Comparison of responses to the three vaccines over time demonstrated differences in the mean geometric anti-PRP antibody level at 1 month (p = 0.03) and the 12 month time points (p = 0.03) with lower geometric mean levels in the HbNOMP group, though baseline differences in groups limit the interpretation of these findings. In a univariate analysis of baseline characteristics which predicted poor vaccine response, low total IgG2 levels preimmunization predicted a poor antibody response at 1 month (p < 0.01) and at 12 months (p=0.05), while low CD4 T-cell count predicted poor response at 12 months (p < 0.01). We conclude that all three US licensed protein conjugate Hib vaccines are immunogenic in HIV-seropositive adults, and that baseline CD4 T-cell count and IgG2 levels predict the likelihood of antibody response to vaccine.
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U2 - 10.1016/S0264-410X(99)00089-4
DO - 10.1016/S0264-410X(99)00089-4
M3 - Article
C2 - 10438047
AN - SCOPUS:0033575488
SN - 0264-410X
VL - 17
SP - 2779
EP - 2785
JO - Vaccine
JF - Vaccine
IS - 22
ER -