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Clinical and Vaccine Immunology, April 2009, p. 479-483, Vol. 16, No. 4
1071-412X/09/$08.00+0 doi:10.1128/CVI.00312-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.
Whole-Cell Pertussis Vaccine Induces Low Antibody Levels in Human Immunodeficiency Virus-Infected Children Living in Sub-Saharan Africa
Mathurin C. Tejiokem,1
Elisabeth Njamkepo,2
Ionela Gouandjika,3
Dominique Rousset,4
Lydie Béniguel,5
Catherine Bilong,6
Gilbert Tene,7
Ida Penda,8
Carine Ngongueu,9
Jean C. Gody,9
Nicole Guiso,2 and
Laurence Baril10*
Laboratoire d'Épidémiologie et de Santé Publique,1 Laboratoire de Virologie,4 Laboratoire d'Analyses Médicales, Centre Pasteur du Cameroun,6 Centre Mère et Enfant de la Fondation Chantal Biya, Yaoundé,7 Service de Pédiatrie, Hôpital Laquintinie, Douala, Cameroon,8 Unité de Recherche Prévention et Thérapie Moléculaires des Maladies Humaines, Institut Pasteur, Paris, France,2 Laboratoire des Entérovirus,3 Laboratoire des Rétrovirus, Institut Pasteur de Bangui,5 Complexe Pédiatrique National, Bangui, Central African Republic,9 Unité d'Épidémiologie des Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal,10
Received 27 August 2008/ Returned for modification 29 October 2008/ Accepted 26 January 2009
The WHO recommendations for the immunization of children infected with human immunodeficiency virus (HIV) differ slightly from the guidelines for uninfected children. The introduction of antiretroviral therapy for HIV-infected infants should considerably prolong their life expectancy. The question of the response to the whole-cell pertussis (wP) vaccine should now be addressed, particularly in countries in which pertussis remains endemic. To evaluate the persistence of antibodies to the wP vaccine in HIV-infected and uninfected children who had previously received this vaccine in routine clinical practice, we conducted a cross-sectional study of children aged 18 to 36 months, born to HIV-infected mothers and living in Cameroon or the Central African Republic. We tested blood samples for antibodies to the wP vaccine and for antibodies to diphtheria and tetanus toxoids (D and T, respectively) in the context of the use of a combined DTwP vaccine. We enrolled 50 HIV-infected children and 78 uninfected, HIV-exposed children in the study. A lower proportion of HIV-infected children than uninfected children had antibodies against the antigens tested for all valences of the DTwP vaccine. Agglutinin levels were substantially lower in HIV-infected than in HIV-exposed but uninfected children (30.0% versus 55.1%, respectively; P = 0.005). We also observed a high risk of low antibody levels in response to the DTwP vaccine in HIV-infected children with severe immunodeficiency (CD4 T-cell level, <25%). The concentrations of antibodies induced by the DTwP vaccine were lower in HIV-infected children than in uninfected children. This study supports the need for a booster dose of the DTwP vaccine in order to maintain high antibody levels in HIV-infected children.
* Corresponding author. Mailing address: Unit of Infectious Disease Epidemiology, Institut Pasteur de Dakar, 36, avenue Pasteur, BP 220, Dakar, Senegal. Phone: 221 33 839 92 46. Fax: 221 33 839 92 10. E-mail: baril{at}pasteur.sn
Published ahead of print on 4 February 2009.
Clinical and Vaccine Immunology, April 2009, p. 479-483, Vol. 16, No. 4
1071-412X/09/$08.00+0 doi:10.1128/CVI.00312-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.
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