Scientific Publications by FDA Staff

Pediatr Infect Dis J 2012 Feb;31(2):176-180

Immunologic Response to Oral Polio Vaccine in Human Immunodeficiency Virus-infected and Uninfected Zimbabwean Children.

Gnanashanmugam D, Troy SB, Musingwini G, Huang C, Halpern MS, Stranix-Chibanda L, Shetty AK, Kouiavskaia D, Nathoo K, Chumakov K, Maldonado YA

BACKGROUND:: Poliovirus eradication is dependent on maintaining adequate community-wide levels of serologic protection. Many African countries with conditions that favor continued wild poliovirus propagation also have a high prevalence of pediatric human immunodeficiency virus (HIV) infection. Data are limited regarding the degree of serologic immunity conferred on HIV-infected children after immunization with oral polio vaccine (OPV). METHODS:: This was a cross-sectional study correlating HIV infection and neutralizing antibodies against poliovirus serotypes 1, 2, and 3 in 95 Zimbabwean children of age 2 months to 2 years, born to HIV-infected mothers, who received OPV according to the national schedule. RESULTS:: HIV-infected children had significantly lower rates of seroconversion to all three polio serotypes than HIV-uninfected children (60%, 67%, and 47% versus 96%, 100%, and 82%, p =0.001, 0.0003, and 0.015 for serotypes 1, 2, and 3 in HIV-infected and uninfected children respectively after >/=3 OPV doses). Among polio seroconverters, HIV-infected children also had significantly lower geometric mean titers against serotypes 1 and 2 than HIV-uninfected children (GMT: 198 and 317 versus 1193 and 1056, p =0.032 and 0.050, for serotypes 1 and 2 respectively after >/=3 OPV doses). In addition, HIV-infected children had significantly higher levels of total IgG and significantly lower CD4% and mean weight than HIV-uninfected children. Of note, none of the HIV-infected children was receiving antiretroviral therapy, and 71% had a CD4% indicating severe immunodeficiency. CONCLUSIONS:: Pediatric HIV infection is associated with a poor serologic response to OPV which could pose an obstacle to global polio eradication.