Impaired antibody memory to varicella zoster virus in HIV-infected children: low antibody levels and avidity*

Autor: A G, L'Huillier, T, Ferry, D S, Courvoisier, C, Aebi, J-J, Cheseaux, C, Kind, C, Rudin, D, Nadal, B, Hirschel, C, Sottas, C-A, Siegrist, K M, Posfay-Barbe, Ch, Berger
Rok vydání: 2011
Předmět:
Zdroj: HIV Medicine, Vol. 13, No 1 (2012) pp. 54-61
ISSN: 1468-1293
1464-2662
Popis: HIV-infected children have impaired antibody responses after exposure to certain antigens. Our aim was to determine whether HIV-infected children had lower varicella zoster virus (VZV) antibody levels compared with HIV-infected adults or healthy children and, if so, whether this was attributable to an impaired primary response, accelerated antibody loss, or failure to reactivate the memory VZV response.In a prospective, cross-sectional and retrospective longitudinal study, we compared antibody responses, measured by enzyme-linked immunosorbent assay (ELISA), elicited by VZV infection in 97 HIV-infected children and 78 HIV-infected adults treated with antiretroviral therapy, followed over 10 years, and 97 age-matched healthy children. We also tested antibody avidity in HIV-infected and healthy children.Median anti-VZV immunoglobulin G (IgG) levels were lower in HIV-infected children than in adults (264 vs. 1535 IU/L; P0.001) and levels became more frequently unprotective over time in the children [odds ratio (OR) 17.74; 95% confidence interval (CI) 4.36-72.25; P0.001]. High HIV viral load was predictive of VZV antibody waning in HIV-infected children. Anti-VZV antibodies did not decline more rapidly in HIV-infected children than in adults. Antibody levels increased with age in healthy (P=0.004) but not in HIV-infected children. Thus, antibody levels were lower in HIV-infected than in healthy children (median 1151 IU/L; P0.001). Antibody avidity was lower in HIV-infected than healthy children (P0.001). A direct correlation between anti-VZV IgG level and avidity was present in HIV-infected children (P=0.001), but not in healthy children.Failure to maintain anti-VZV IgG levels in HIV-infected children results from failure to reactivate memory responses. Further studies are required to investigate long-term protection and the potential benefits of immunization.
Databáze: OpenAIRE
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