Body Mass Index and Vaccine-induced Immune Responses in Children Living With HIV.

BACKGROUND

Children living with HIV are experiencing rising rates of obesity, driven by both the side effects of antiretroviral therapy and the increasingly obesogenic environments. Obesity and HIV are both known to cause immune dysregulation, which may have a combined negative effect on vaccine-induced immune response in this vulnerable population. This study aimed to determine whether body mass index z-score (BMIz) is associated with vaccine-induced antibody concentrations in children living with HIV.

METHODS

This study used data from clinical trials for 3 separate vaccines (hepatitis A, hepatitis B and pneumococcal [conjugate plus polysaccharide]) administered to children living with HIV. Enrollment was between September 1999 and March 2003 in the United States. Adjusted linear regression for interval-censored data and logistic regression models were used to assess associations for BMIz with antibody response up to 104 weeks after vaccine administration.

RESULTS

Participant age ranged from 2 to 20 years old. Analyses included 150 participants for the hepatitis A vaccine, 154 for the hepatitis B vaccine and 214 for the pneumococcal vaccine. BMIz was associated with hepatitis B antibody concentration 8 weeks after vaccination ( P = 0.026) with the highest probability (47%) of seroconversion for participants with BMIz near 1. There was no statistically significant association between BMIz and antibody response for the hepatitis A vaccine or 4 of 5 studied serotypes in the pneumococcal vaccine (n = 214).

CONCLUSIONS

The hepatitis A, hepatitis B and pneumococcal vaccines are likely adequate as administered and protective for children living with HIV at a broad range of BMI.