RESPONSE TO TETANUS TOXOID PRIMARY IMMUNIZATION IN CHILDREN BORN TO HIV-SEROPOSITIVE MOTHERS

Pre- and postvaccination antitetanus (AT) antibody values were investi gated in children born to human immunodeficiency virus type 1 (HIV-1)- infected mothers. Twenty-four uninfected and 14 infected children were enrolled in the study as judged by the Centers for Disease Control an d Prevention (CDC) classification system and viral isolation or PCR as says. AT antibody values were determined in sera by hemagglutination a ssay. CD4 lymphocyte counts, serum immunoglobulins, and p24 antigenemi a were also evaluated. Prior to vaccination concentrations of immunogl obulins were higher and CD4 positive lymphocyte counts were lower in t he infected infants than in the noninfected infants. Following primary vaccination, an appropriate antibody response was found in 22 (92%) o f 24 uninfected children and in 4 (29%) of 14 infected ones. Mean AT a ntibody levels were lower in infected than in uninfected infants, with values differing more significantly after the second tetanus toxoid ( TT) administration (p values: 0.06, 0.01, and 0.03 after the first, se cond, and third doses, respectively). Also, uninfected children showed a more than 4-fold rise in specific antibody concentration after the second TT immunization, which was not found in infected infants (1.1-4 .28 HU/ml vs 0.27-0.31 HU/ml in uninfected and infected children, resp ectively). Among the infected children no difference in the AT antibod y levels of those with acquired immunodeficiency syndrome (AIDS) and t hose with non-AIDS status could be detected. In conclusion, our data c onfirm that symptomatic HIV-1-infected infants have a reduced capacity to sustain an antibody response to recall antigens.