Vaccine · 2018
Immune response to a Tdap booster in vertically HIV-infected adolescents.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Spina Fernanda Garcia, Gouvea Aída, Succi Regina Célia de Menezes, Calanca Flavia, Weckx Lily Yin, Terreri Maria Teresa, Takano Maria Aparecida Sakauchi, de Moraes-Pinto Maria Isabel
Аннотация
BACKGROUND: Pertussis cases have increased worldwide and knowledge on immune response and cytokine profile after Tdap vaccine in immunodeficient adolescents is scarce.
OBJECTIVE: To evaluate the immune response after Tdap in HIV-infected (HIV) and in healthy adolescents (CONTROL).
METHODOLOGY: Thirty HIV adolescents with CD4 cell counts >200 and 30 CONTROLs were immunized with Tdap, after a prior whole-cell DTP vaccine primary scheme. Blood samples were collected immediately before and after vaccine. Lymphocyte immunophenotyping was performed by flow cytometry; tetanus, diphtheria and pertussis toxin antibodies were assessed by ELISA; whole blood was stimulated with tetanus toxoid and Bordetella pertussis and supernatants were assessed for cytokines by xMAP.
RESULTS: Mean age of HIV and CONTROL groups were 17.9 e 17.1 years, respectively. Pain at injection site was more intense in CONTROL group. HIV group had similar increase in tetanus antibodies at 28 days (geometric mean concentration, GMC, 15.6; 95% CI, 7.52-32.4) than CONTROL group (GMC, 23.1; 95% CI, 15.0-35.5), but lower diphtheria antibodies at 28 days (GMC, 2.3; 95% CI, 0.88-6.19) than CONTROL group (GMC, 16.4; 95% CI, 10.3-26.2); for pertussis, the percentage of individuals who seroconverted was lower in HIV than CONTROL group (HIV, 62.1% versus CONTROL, 100%; p = .002). Both groups built a cellular immune response to tetanus, with a Th2 (IL-4, IL-5 and IL-13) and Th1 (IFN-γ) response, with lower cytokine levels in HIV than in CONTROL group. Especially for pertussis, cellular and humoral responses were less intense in HIV adolescents, with a lower Th1 and Th17 profile and higher IL-10 levels. HIV-infected adolescents on viral suppression showed an enhanced immune response to all the three vaccine antigens, although still at lower levels if compared to CONTROL group.
CONCLUSIONS: Both groups tolerated well and built an immune response after Tdap. However, HIV-infected adolescents would probably benefit from more frequent booster doses.
OBJECTIVE: To evaluate the immune response after Tdap in HIV-infected (HIV) and in healthy adolescents (CONTROL).
METHODOLOGY: Thirty HIV adolescents with CD4 cell counts >200 and 30 CONTROLs were immunized with Tdap, after a prior whole-cell DTP vaccine primary scheme. Blood samples were collected immediately before and after vaccine. Lymphocyte immunophenotyping was performed by flow cytometry; tetanus, diphtheria and pertussis toxin antibodies were assessed by ELISA; whole blood was stimulated with tetanus toxoid and Bordetella pertussis and supernatants were assessed for cytokines by xMAP.
RESULTS: Mean age of HIV and CONTROL groups were 17.9 e 17.1 years, respectively. Pain at injection site was more intense in CONTROL group. HIV group had similar increase in tetanus antibodies at 28 days (geometric mean concentration, GMC, 15.6; 95% CI, 7.52-32.4) than CONTROL group (GMC, 23.1; 95% CI, 15.0-35.5), but lower diphtheria antibodies at 28 days (GMC, 2.3; 95% CI, 0.88-6.19) than CONTROL group (GMC, 16.4; 95% CI, 10.3-26.2); for pertussis, the percentage of individuals who seroconverted was lower in HIV than CONTROL group (HIV, 62.1% versus CONTROL, 100%; p = .002). Both groups built a cellular immune response to tetanus, with a Th2 (IL-4, IL-5 and IL-13) and Th1 (IFN-γ) response, with lower cytokine levels in HIV than in CONTROL group. Especially for pertussis, cellular and humoral responses were less intense in HIV adolescents, with a lower Th1 and Th17 profile and higher IL-10 levels. HIV-infected adolescents on viral suppression showed an enhanced immune response to all the three vaccine antigens, although still at lower levels if compared to CONTROL group.
CONCLUSIONS: Both groups tolerated well and built an immune response after Tdap. However, HIV-infected adolescents would probably benefit from more frequent booster doses.
Предметные рубрики MeSH
AdolescentAntibodies, BacterialAntigens, BacterialChildCytokinesDiphtheriaDiphtheria-Tetanus VaccineDiphtheria-Tetanus-acellular Pertussis VaccinesFemaleHIV InfectionsHumansImmunity, CellularImmunity, HumoralImmunization, SecondaryInfectious Disease Transmission, VerticalMaleT-Lymphocytes, Helper-InducerTetanusTetanus ToxoidWhooping CoughYoung Adult