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ABSTRACT
It remains uncertain whether HIV-exposed uninfected (HEU) infants have impaired responses to oral vaccines. We performed a cross-sectional study of 6-month-old infants recruited at birth to the ZVITAMBO trial in Zimbabwe between 1997–2001, before introduction of prevention of mother-to-child transmission interventions. We measured poliovirus-specific IgA to type 1–3 polio strains by semi-quantitative capture ELISA in cryopreserved serum samples collected from 85 HEU and 101 HIV-unexposed infants at 6 months of age, one month after their last immunisation with trivalent OPV. Almost all infants were breastfed, with the majority in both groups mixed breastfed (70.6% HEU versus 71.3% HIV-unexposed). Median (IQR) vaccine titers for HEU and HIV-unexposed infants were 1592 (618–4896) vs. 1774 (711–5431) for Sabin 1 (P = 0.46); 1895 (810–4398) vs. 2308 (1081–4283) for Sabin 2 (P = 0.52); and 1798 (774–4192) vs. 2260 (996–5723) for Sabin 3 (P = 0.18). There were no significant differences in vaccine titers between HEU and HIV-unexposed infants, suggesting that vertical HIV exposure does not impact oral poliovirus vaccine immunogenicity.
Disclosure of potential conflicts of interest
No potential conflicts of interest were disclosed.
Acknowledgments
We thank the mothers and babies who participated in the ZVITAMBO trial, and the ZVITAMBO Study Group. JAC, MPC, SAD conceived and designed the experiments. JAC, MG, SR performed the experiments. JAC, BC, RN and AJP analyzed the data. JAC, MPC, SAD, RN, JH, BDK and AJP wrote the paper. We are also grateful to WC Weldon for his helpful comments on this manuscript and his work with AJ Williams at the Centers for Disease Control and Prevention in developing the Polio IgA capture ELISA method.
Funding
The ZVITAMBO trial was supported by the Canadian International Development Agency (CIDA) (R/C Project 690/M3688), United States Agency for International Development (USAID) (cooperative agreement number HRN-A-00–97–00015–00 between Johns Hopkins University and the Office of Health and Nutrition – USAID) and a grant from the Bill and Melinda Gates Foundation, Seattle WA. Additional funding was received from the SARA Project, which is operated by the Academy for Educational Development, Washington DC and is funded by USAID's Bureau for Africa, Office of Sustainable Development under the terms of Contract AOT-C-00–99–00237–00, the Rockefeller Foundation (NY, NY) and BASF (Ludwigshafen, Germany). This current study was supported by the Sanitation & Hygiene Applied Research for Equity (SHARE) Consortium and Barts Charity (grant number 212563 to JAC). JAC (Grant 201293/Z/16/Z) and AJP (Grant 108065/Z/15/Z) are supported by the Wellcome Trust.