PMID- 30417710 OWN - NLM STAT- MEDLINE DCOM- 20190403 LR - 20191112 IS - 1744-8395 (Electronic) IS - 1476-0584 (Print) IS - 1476-0584 (Linking) VI - 18 IP - 1 DP - 2019 Jan TI - Effect of HIV exposure and timing of antiretroviral therapy initiation on immune memory responses to diphtheria, tetanus, whole cell pertussis and hepatitis B vaccines. PG - 95-104 LID - 10.1080/14760584.2019.1547195 [doi] AB - OBJECTIVES: We evaluated memory responses and antibody persistence to diphtheria-toxoid, tetanus-toxoid, whole-cell-pertussis (DTwP), and Hepatitis-B vaccines in HIV-unexposed, HIV-exposed-uninfected and HIV-infected children previously randomized to initiate time-limited ART at 6-10 weeks (ART-Immed) or when clinically/immunologically indicated (ART-Def). METHODS: All children received DTwP booster at 15-18 months. Antibodies were measured for pertussis-toxoid, filamentous haemagglutinin (FHA), diphtheria-toxoid, tetanus-toxoid, and hepatitis-B prior to booster, 1-2 weeks post-booster and at 24 months of age. RESULTS: Pre-booster antibody GMC were lower in HIV-infected groups than HIV-unexposed children for all epitopes. Post-booster and at 24 months of age, the ART-Def group had lower GMCs and antibody proportion >/=0.1 IU/ml for tetanus-toxoid and diphtheria-toxoid compared to HIV-unexposed children. At 24 months of age, the ART-Immed group had higher GMCs, and more likely to maintain antibody titres >/=1.0 IU/ml to tetanus-toxoid and diphtheria-toxoid compared to HIV-unexposed children. Compared to HIV-unexposed children, at 15 and 24 months of age, persistence of antibody to HBsAg of >/=10 mIU/ml was similar in the ART-Immed group but lower among the ART-Def group. Antibody kinetics indicated more robust memory responses in HIV-exposed-uninfected than HIV-unexposed children to diphtheria-toxoid and wP. CONCLUSION: HIV-infected children not on ART at primary vaccination had poorer memory responses, whereas HIV-exposed-uninfected children mounted robust memory responses. FAU - Simani, Omphile E AU - Simani OE AD - a Department of Science and Technology, Health Sciences , National Research Foundation:Vaccine Preventable Diseases University of the Witwatersrand , Johannesburg , South Africa. AD - b Health Sciences , Medical Research Council: Respiratory & Meningeal Pathogens Research Unit, University of the Witwatersrand , Johannesburg , South Africa. FAU - Izu, Alane AU - Izu A AD - a Department of Science and Technology, Health Sciences , National Research Foundation:Vaccine Preventable Diseases University of the Witwatersrand , Johannesburg , South Africa. AD - b Health Sciences , Medical Research Council: Respiratory & Meningeal Pathogens Research Unit, University of the Witwatersrand , Johannesburg , South Africa. FAU - Nunes, Marta C AU - Nunes MC AUID- ORCID: 0000-0003-3788-878X AD - a Department of Science and Technology, Health Sciences , National Research Foundation:Vaccine Preventable Diseases University of the Witwatersrand , Johannesburg , South Africa. AD - b Health Sciences , Medical Research Council: Respiratory & Meningeal Pathogens Research Unit, University of the Witwatersrand , Johannesburg , South Africa. FAU - Violari, Avy AU - Violari A AD - c Health Sciences , Perinatal HIV Research Unit, University of the Witwatersrand , Johannesburg , South Africa. FAU - Cotton, Mark F AU - Cotton MF AD - d Family Clinical Research Unit, Department of Pediatrics and Child Health, Medicine and Health Sciences , Stellenbosch University , Tygerberg , South Africa. FAU - Van Niekerk, Nadia AU - Van Niekerk N AD - a Department of Science and Technology, Health Sciences , National Research Foundation:Vaccine Preventable Diseases University of the Witwatersrand , Johannesburg , South Africa. AD - b Health Sciences , Medical Research Council: Respiratory & Meningeal Pathogens Research Unit, University of the Witwatersrand , Johannesburg , South Africa. FAU - Adrian, Peter V AU - Adrian PV AD - a Department of Science and Technology, Health Sciences , National Research Foundation:Vaccine Preventable Diseases University of the Witwatersrand , Johannesburg , South Africa. AD - b Health Sciences , Medical Research Council: Respiratory & Meningeal Pathogens Research Unit, University of the Witwatersrand , Johannesburg , South Africa. FAU - Madhi, Shabir A AU - Madhi SA AUID- ORCID: 0000-0002-7629-0636 AD - a Department of Science and Technology, Health Sciences , National Research Foundation:Vaccine Preventable Diseases University of the Witwatersrand , Johannesburg , South Africa. AD - b Health Sciences , Medical Research Council: Respiratory & Meningeal Pathogens Research Unit, University of the Witwatersrand , Johannesburg , South Africa. LA - eng GR - U19 AI053217/AI/NIAID NIH HHS/United States GR - HHSN272200800014C/AI/NIAID NIH HHS/United States PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20181119 PL - England TA - Expert Rev Vaccines JT - Expert review of vaccines JID - 101155475 RN - 0 (Anti-HIV Agents) RN - 0 (Antibodies) RN - 0 (Diphtheria-Tetanus-Pertussis Vaccine) RN - 0 (Hepatitis B Vaccines) SB - IM MH - Anti-HIV Agents/*administration & dosage MH - Antibodies/immunology MH - Child, Preschool MH - Diphtheria-Tetanus-Pertussis Vaccine/administration & dosage/*immunology MH - Female MH - HIV Infections/drug therapy/*epidemiology MH - Hepatitis B Vaccines/administration & dosage/*immunology MH - Humans MH - Immunization, Secondary/methods MH - Immunologic Memory MH - Infant MH - Male MH - Time Factors PMC - PMC6842654 MID - NIHMS1055924 OTO - NOTNLM OT - Diphtheria-toxoid OT - HIV-exposed uninfected OT - HIV-infected OT - booster OT - hepatitis B vaccine OT - pertussis vaccine OT - tetanus-toxoid EDAT- 2018/11/13 06:00 MHDA- 2019/04/04 06:00 PMCR- 2019/11/11 CRDT- 2018/11/13 06:00 PHST- 2018/11/13 06:00 [pubmed] PHST- 2019/04/04 06:00 [medline] PHST- 2018/11/13 06:00 [entrez] PHST- 2019/11/11 00:00 [pmc-release] AID - 10.1080/14760584.2019.1547195 [doi] PST - ppublish SO - Expert Rev Vaccines. 2019 Jan;18(1):95-104. doi: 10.1080/14760584.2019.1547195. Epub 2018 Nov 19.