ANTIBODY-TITERS 8 MONTHS AFTER 3 DOSES OF A 5-VALENT PNEUMOCOCCAL CONJUGATE VACCINE IN HIV AND NON-HIV-INFECTED CHILDREN LESS-THAN 2 YEARS OF AGE

The objective of this study was to examine vaccine type-specific antib ody titers eight months after a five-valent pneumococcal conjugate vac cine (PCV) in human immunodeficiency virus (HIV) and non-HIV-infected children under two years of age. Sixteen HIV-infected and 14 non-HIV-i nfected children under two years of age, and of similar age, race and sex distribution, received three doses (separated by two months each) of a five-valent oligosaccharide PCV (types 6B, 14, 18C, 19F, and 23F separately coupled to diphtheria CRM197). An additional 11 non-HIV-inf ected children, of similar demographic distribution to the PCV groups, received three doses of saline placebo. Sera were collected just prio r to, and at one and eight months after the three study drug doses. Se rum vaccine type-specific pneumococcal IgG antibodies were measured by enzyme-linked immunoabsorbant assay (ELISA). There was an impressive rise in antibody titers pre- to one month post-third PCV in both the H IV (58-970-fold) and non-HIV-infected (19-553-fold) children. There wa s a rapid and similar drop in antibody titers eight months after the P CV series for both HIV (range 69-87% drop) and non-HIV-infected (range 57-79% drop) subjects respectively. However, 46% of the antibody tite rs from HIV-infected children and 62% of the titers from non-HIV-infec ted children were still >1.0 mu g ml(-1) compared to placebo recipient s for whom only 5% of the titers were >1.0 mu g ml(-1) (p<0.05). At th e eight month post-PCV series blood draw, there were no significant di fferences in the GMTs, the percent drop in titers, or proportion of ti ters >1.0 mu g ml(-1) between the five HIV-infected children who had a dvanced (CDC class: N3, A3, B2-3, C1-3) compared to the 11 children wi th mild (CDC class: N1-2, A1-2, B1) HIV disease at the time of their f irst PCV dose. Eight months after the PCV series, the proportion of ti ters (combined all five serotypes) >1.0 mu g ml(-1) was slightly, but significantly, lower for HIV-infected subjects (46%) compared to non-H IV-infected young children. (C) 1998 Published by Elsevier Science Ltd . All rights reserved.