Immunogenicity of three Haemophilus influenzae type b protein conjugate vaccines in HIV seropositive adults and analysis of predictors of vaccine response

Vaccine. 1999 Jul 16;17(22):2779-85. doi: 10.1016/s0264-410x(99)00089-4.

Abstract

HIV-seropositive adults may be at increased risk of infection due to Haemophilus influenzae type b (Hib) as compared with HIV-seronegative adults. Protein conjugate vaccines have been demonstrated to induce protective levels of antibodies against Hib in immunocompetent infants and also in HIV-seropositive infants. In this study we determined the immunogenicity of three protein conjugate Hib vaccines (PRP-D, HbOC, HbNOMP) in 135 HIV-seropositive adults who received one dose of Hib vaccine. Anti-polyribosylribitol phosphate (PRP) antibodies were measured at 0, 1, 3 and 12 months postimmunization by the Farr method. We demonstrate that all three vaccines are highly immunogenic and result in protective (> 1.0 microg/ml) levels of antibody. Overall the anti-PRP antibody level was > 1.0 microg/ml in 26% of patients preimmunization, 91% at both 1 and 3 months, and 79% at 12 months postvaccination. Comparison of responses to the three vaccines over time demonstrated differences in the mean geometric anti-PRP antibody level at 1 month (p=0.03) and the 12 month time points (p=0.03) with lower geometric mean levels in the HbNOMP group, though baseline differences in groups limit the interpretation of these findings. In a univariate analysis of baseline characteristics which predicted poor vaccine response, low total IgG2 levels preimmunization predicted a poor antibody response at 1 month (p < 0.01) and at 12 months (p=0.05), while low CD4 T-cell count predicted poor response at 12 months (p < 0.01). We conclude that all three US licensed protein conjugate Hib vaccines are immunogenic in HIV-seropositive adults, and that baseline CD4 T-cell count and IgG2 levels predict the likelihood of antibody response to vaccine.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Antibodies, Bacterial / blood
  • Bacterial Outer Membrane Proteins / immunology*
  • Bacterial Outer Membrane Proteins / therapeutic use
  • Forecasting
  • HIV Seropositivity / immunology*
  • HIV Seropositivity / microbiology
  • Haemophilus Infections / prevention & control*
  • Haemophilus Vaccines / immunology*
  • Haemophilus Vaccines / therapeutic use
  • Haemophilus influenzae / immunology*
  • Humans
  • Male
  • Middle Aged
  • Sex Factors
  • Vaccines, Conjugate / immunology
  • Vaccines, Conjugate / therapeutic use

Substances

  • Antibodies, Bacterial
  • Bacterial Outer Membrane Proteins
  • Haemophilus Vaccines
  • Vaccines, Conjugate
  • outer membrane protein P1, Haemophilus influenzae type b