TY - JOUR
T1 - Prevalence and Persistence of Varicella Antibodies in Previously Immunized Children and Youth with Perinatal HIV-1 Infection
AU - Pediatric HIV/AIDS Cohort Study (PHACS)
AU - Purswani, Murli U.
AU - Karalius, Brad
AU - Yao, Tzy Jyun
AU - Schmid, D. Scott
AU - Burchett, Sandra K.
AU - Siberry, George K.
AU - Patel, Kunjal
AU - Van Dyke, Russell B.
AU - Yogev, Ram
AU - Sanders, Margaret Ann
AU - Malee, Kathleen
AU - Hunter, Scott
AU - Shearer, William
AU - Paul, Mary
AU - Cooper, Norma
AU - Harris, Lynnette
AU - Purswani, Murli
AU - Baig, Mahboobullah
AU - Cintron, Anna
AU - Puga, Ana
AU - Navarro, Sandra
AU - Garvie, Patricia
AU - Blood, James
AU - Burchett, Sandra
AU - Karthas, Nancy
AU - Kammerer, Betsy
AU - Wiznia, Andrew
AU - Burey, Marlene
AU - Nozyce, Molly
AU - Dieudonne, Arry
AU - Bettica, Linda
AU - Adubato, Susan
AU - Chen, Janet
AU - Bulkley, Maria Garcia
AU - Ivey, Latreaca
AU - Grant, Mitzie
AU - Knapp, Katherine
AU - Allison, Kim
AU - Wilkins, Megan
AU - Acevedo-Flores, Midnela
AU - Rios, Heida
AU - Olivera, Vivian
AU - Silio, Margarita
AU - Jones, Medea
AU - Sirois, Patricia
AU - Spector, Stephen
AU - Norris, Kim
AU - Nichols, Sharon
AU - Mcfarland, Elizabeth
N1 - Funding Information:
We thank the children and families for their participation in Pediatric HIV/AIDS Cohort Study (PHACS), and the individuals and institutions involved in the conduct of PHACS. The following institutions (in alphabetical order), clinical site investigators, and staff participated in conducting PHACS Adolescent Master Protocol in 2014: Ann & Robert H. Lurie Children''s Hospital of Chicago: Ram Yogev, Margaret Ann Sanders, Kathleen Malee, Scott Hunter; Baylor College of Medicine: William Shearer, Mary Paul, Norma Cooper, Lynnette Harris; Bronx Lebanon Hospital Center: Murli Purswani, Mahboobullah Baig, Anna Cintron; Children''s Diagnostic & Treatment Center: Ana Puga, Sandra Navarro, Patricia Garvie, James Blood; Children''s Hospital, Boston: Sandra Burchett, Nancy Karthas, Betsy Kammerer; Jacobi Medical Center: AndrewWiznia, Marlene Burey, Molly Nozyce; Rutgers–New Jersey Medical School: Arry Dieudonne, Linda Bettica, Susan Adubato; St. Christopher''s Hospital for Children: Janet Chen, Maria Garcia Bulkley, Latreaca Ivey, Mitzie Grant; St. Jude Children''s Research Hospital: Katherine Knapp, Kim Allison, MeganWilkins; San Juan Hospital/Department of Pediatrics: Midnela Acevedo-Flores, Heida Rios, Vivian Olivera; Tulane University Health Sciences Center: Margarita Silio, Medea Jones, Patricia Sirois; University of California, San Diego: Stephen Spector, Kim Norris, Sharon Nichols; University of Colorado Denver Health Sciences Center: Elizabeth McFarland, Alisa Katai, Jennifer Dunn, Suzanne Paul; University of Miami: Gwendolyn Scott, Patricia Bryan, Elizabeth Willen. B. K. and T.-J. Y. had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Conception and design of the study: M. U. P., B. K., T.-J. Y., and R. Y. Acquisition, analysis, and interpretation of data: All authors. Drafting ofmanuscript: M. U. P., B. K., T.-J. Y., and R. Y. Revision ofmanuscript: All authors. Statistical analysis: B. K., and T.-J. Y. Administrative, technical, or material support: All authors. Supervision of the study: M. U. P., D. S. S., R. Y., and R. B. V. D. Disclaimer. The conclusions and opinions expressed in this article are those of the authors and do not necessarily reflect those of the National Institutes of Health or US Department of Health and Human Services. The PHACS was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development with co-funding from the National Institute on Drug Abuse, the National Institute of Allergy and Infectious Diseases, the Office of AIDS Research, the National Institute of Mental Health, the National Institute of Neurological Disorders and Stroke, the National Institute on Deafness and Other Communication Disorders, the National Heart Lung and Blood Institute, the National Institute of Dental and Craniofacial Research, and the National Institute on Alcohol Abuse and Alcoholism, through cooperative agreements with the Harvard T.H. Chan School of Public Health (HD052102; Principal Investigator: George Seage; Project Director: Julie Alperen) and the Tulane University School of Medicine (HD052104; Principal Investigator: Russell Van Dyke; Co-Principal Investigator: Kenneth Rich; Project Director: Patrick Davis). Data management services were provided by Frontier Science and Technology Research Foundation (Principal Investigator: Suzanne Siminski), and regulatory services and logistical support were provided by Westat, Inc (Principal Investigator: Julie Davidson). No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
Funding Information:
We thank the children and families for their participation in Pediatric HIV/AIDS Cohort Study (PHACS), and the individuals and institutions involved in the conduct of PHACS. The following institutions (in alphabetical order), clinical site investigators, and staff participated in conducting PHACS Adolescent Master Protocol in 2014: Ann & Robert H. Lurie Children''s Hospital of Chicago: Ram Yogev, Margaret Ann Sanders, Kathleen Malee, Scott Hunter; Baylor College of Medicine: William Shearer, Mary Paul, Norma Cooper, Lynnette Harris; Bronx Lebanon Hospital Center: Murli Purswani, Mahboobullah Baig, Anna Cintron; Children''s Diagnostic & Treatment Center: Ana Puga, Sandra Navarro, Patricia Garvie, James Blood; Children''s Hospital, Boston: Sandra Burchett, Nancy Karthas, Betsy Kammerer; Jacobi Medical Center: AndrewWiznia, Marlene Burey, Molly Nozyce; Rutgers?New Jersey Medical School: Arry Dieudonne, Linda Bettica, Susan Adubato; St. Christopher''s Hospital for Children: Janet Chen, Maria Garcia Bulkley, Latreaca Ivey, Mitzie Grant; St. Jude Children''s Research Hospital: Katherine Knapp, Kim Allison, MeganWilkins; San Juan Hospital/Department of Pediatrics: Midnela Acevedo-Flores, Heida Rios, Vivian Olivera; Tulane University Health Sciences Center: Margarita Silio, Medea Jones, Patricia Sirois; University of California, San Diego: Stephen Spector, Kim Norris, Sharon Nichols; University of Colorado Denver Health Sciences Center: Elizabeth McFarland, Alisa Katai, Jennifer Dunn, Suzanne Paul; University of Miami: Gwendolyn Scott, Patricia Bryan, Elizabeth Willen. B. K. and T.-J. Y. had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Conception and design of the study: M. U. P., B. K., T.-J. Y., and R. Y. Acquisition, analysis, and interpretation of data: All authors. Drafting ofmanuscript: M. U. P., B. K., T.-J. Y., and R. Y. Revision ofmanuscript: All authors. Statistical analysis: B. K., and T.-J. Y. Administrative, technical, or material support: All authors. Supervision of the study: M. U. P., D. S. S., R. Y., and R. B. V. D. Disclaimer. The conclusions and opinions expressed in this article are those of the authors and do not necessarily reflect those of the National Institutes of Health or US Department of Health and Human Services. The PHACS was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development with co-funding from the National Institute on Drug Abuse, the National Institute of Allergy and Infectious Diseases, the Office of AIDS Research, the National Institute of Mental Health, the National Institute of Neurological Disorders and Stroke, the National Institute on Deafness and Other Communication Disorders, the National Heart Lung and Blood Institute, the National Institute of Dental and Craniofacial Research, and the National Institute on Alcohol Abuse and Alcoholism, through cooperative agreements with the Harvard T.H. Chan School of Public Health (HD052102; Principal Investigator: George Seage; Project Director: Julie Alperen) and the Tulane University School of Medicine (HD052104; Principal Investigator: Russell Van Dyke; Co-Principal Investigator: Kenneth Rich; Project Director: Patrick Davis). Data management services were provided by Frontier Science and Technology Research Foundation (Principal Investigator: Suzanne Siminski), and regulatory services and logistical support were provided by Westat, Inc (Principal Investigator: Julie Davidson). No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
Publisher Copyright:
© 2015 The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Background.Two doses of live-attenuated varicella-zoster vaccine are recommended for human immunodeficiency virus 1 (HIV-1)-infected children with CD4% ≥15%. We determined the prevalence and persistence of antibody in immunized children with perinatal HIV (PHIV) and their association with number of vaccinations, combination antiretroviral therapy (cART), and HIV status. Methods.The Adolescent Master Protocol is an observational study of children with PHIV and perinatally HIV-exposed but uninfected (PHEU) children conducted at 15 US sites. In a cross-sectional analysis, we tested participants' most recent stored sera for varicella antibody using whole-cell and glycoprotein enzyme-linked immunosorbent assay. Seropositivity predictors were identified using multivariable logistic regression models and C statistics. Results.Samples were available for 432 children with PHIV and 221 PHEU children; 82% of children with PHIV and 97% of PHEU children were seropositive (P <. 001). Seropositivity after 1 vaccine dose among children with PHIV and PHEU children was 100% at <3 years (both), 73% and 100% at 3-<7 years (P <. 05), and 77% and 97% at ≥7 years (P <. 01), respectively. Seropositivity among recipients of 2 vaccine doses was >94% at all intervals. Independent predictors of seropositivity among children with PHIV were receipt of 2 vaccine doses, receipt of 1 dose while on ≥3 months of cART, compared with none (adjusted odds ratio [aOR]: 14.0 and 2.8, respectively; P <. 001 for overall dose effect), and in those vaccinated ≥3 years previously, duration of cART (aOR: 1.29 per year increase, P =. 02). Conclusions.Humoral immune responses to varicella vaccine are best achieved when children with PHIV receive their first dose ≥3 months after cART initiation and maintained by completion of the 2-dose series and long-term cART use.
AB - Background.Two doses of live-attenuated varicella-zoster vaccine are recommended for human immunodeficiency virus 1 (HIV-1)-infected children with CD4% ≥15%. We determined the prevalence and persistence of antibody in immunized children with perinatal HIV (PHIV) and their association with number of vaccinations, combination antiretroviral therapy (cART), and HIV status. Methods.The Adolescent Master Protocol is an observational study of children with PHIV and perinatally HIV-exposed but uninfected (PHEU) children conducted at 15 US sites. In a cross-sectional analysis, we tested participants' most recent stored sera for varicella antibody using whole-cell and glycoprotein enzyme-linked immunosorbent assay. Seropositivity predictors were identified using multivariable logistic regression models and C statistics. Results.Samples were available for 432 children with PHIV and 221 PHEU children; 82% of children with PHIV and 97% of PHEU children were seropositive (P <. 001). Seropositivity after 1 vaccine dose among children with PHIV and PHEU children was 100% at <3 years (both), 73% and 100% at 3-<7 years (P <. 05), and 77% and 97% at ≥7 years (P <. 01), respectively. Seropositivity among recipients of 2 vaccine doses was >94% at all intervals. Independent predictors of seropositivity among children with PHIV were receipt of 2 vaccine doses, receipt of 1 dose while on ≥3 months of cART, compared with none (adjusted odds ratio [aOR]: 14.0 and 2.8, respectively; P <. 001 for overall dose effect), and in those vaccinated ≥3 years previously, duration of cART (aOR: 1.29 per year increase, P =. 02). Conclusions.Humoral immune responses to varicella vaccine are best achieved when children with PHIV receive their first dose ≥3 months after cART initiation and maintained by completion of the 2-dose series and long-term cART use.
KW - HIV
KW - antibodies
KW - perinatal
KW - vaccine
KW - varicella
UR - http://www.scopus.com/inward/record.url?scp=84954310697&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84954310697&partnerID=8YFLogxK
U2 - 10.1093/cid/civ734
DO - 10.1093/cid/civ734
M3 - Article
C2 - 26385992
AN - SCOPUS:84954310697
SN - 1058-4838
VL - 62
SP - 106
EP - 114
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 1
ER -
