Published online July 17, 2006
PEDIATRICS Vol. 118 No. 2 August 2006, pp. e315-e322 (doi:10.1542/peds.2005-2616)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bekker, V.
Right arrow Articles by Kuijpers, T. W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bekker, V.
Right arrow Articles by Kuijpers, T. W.
Related Collections
Right arrow Infectious Disease & Immunity
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Persistent Humoral Immune Defect in Highly Active Antiretroviral Therapy–Treated Children With HIV-1 Infection: Loss of Specific Antibodies Against Attenuated Vaccine Strains and Natural Viral Infection

Vincent Bekker, MDa, Henriëtte Scherpbier, MDa, Dasja Pajkrt, MD, PhDa, Suzanne Jurriaans, PhDb, Hans Zaaijer, MD, PhDc and Taco W. Kuijpers, MD, PhDa

a Emma Children's Hospital
b Departments of Human Retrovirology
c Medical Microbiology, Section of Clinical Virology, Academic Medical Center, Amsterdam, Netherlands

OBJECTIVE. In the pre–highly active antiretroviral therapy era, a loss of specific antibodies was seen. Our objective with this study was to describe the loss of specific antibodies during treatment with highly active antiretroviral therapy.

METHODS. In a prospective, single-center, cohort study of 59 children with HIV-1 infection, we investigated the long-term effect of highly active antiretroviral therapy on the titers and course of specific antibodies against measles, mumps, and rubella vaccine strains compared with wild-type varicella zoster virus, cytomegalovirus, and Epstein-Barr virus.

RESULTS. During highly active antiretroviral therapy, age-adjusted CD4+ T cells and B cells increased, whereas total immunoglobulin levels declined. Although these children were preimmunized before the start of highly active antiretroviral therapy, only 24 (43%) had antibodies against all 3 measles, mumps, and rubella. Antibodies against measles, mumps, and rubella were lost in 14 (40%), 11 (38%), and 5 (11%) children who were seropositive at baseline. We also observed loss of varicella zoster virus immunoglobulin G in 7 (21%) of 34, cytomegalovirus immunoglobulin G in 3 (7%) of 45, but none of 53 Epstein-Barr virus–seropositive children. During highly active antiretroviral therapy, primary vaccination in 3 patients and 15 revaccinations in those with negative serology demonstrated incomplete seroconversion.

CONCLUSIONS. Humoral reactivity in children with HIV-1 infection remains abnormal during highly active antiretroviral therapy. Despite immune reconstitution, antibodies against live-attenuated vaccine and wild-type natural virus strains disappear over time in up to 40% of children with HIV-1 infection.

Key Words: pediatric HIV • MMR vaccination • VZV serology • immunoglobulin • CD19

Abbreviations: HAART—highly active antiretroviral therapy • MMR—measles—mumps—and rubella • VZV—varicella zoster virus • CMV—cytomegalovirus • EBV—Epstein-Barr virus • RVP—Rijksvaccintieprogramma (state vaccination program) • pVL—plasma viral load • AU—arbitrary units • Ig—immunoglobulin • VCA—viral capsid antigen

Accepted Feb 21, 2006.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Proc. Natl. Acad. Sci. USAHome page
S. Pensieroso, A. Cagigi, P. Palma, A. Nilsson, C. Capponi, E. Freda, S. Bernardi, R. Thorstensson, F. Chiodi, and P. Rossi
From the Cover: Timing of HAART defines the integrity of memory B cells and the longevity of humoral responses in HIV-1 vertically-infected children
PNAS, May 12, 2009; 106(19): 7939 - 7944.
[Abstract] [Full Text] [PDF]