AIDSWEEKLY Plus, October 21, 1996
Daniel J. DeNoon, Senior Editor

The finding suggests that HIV(+) children, who are at increased risk of bacterial infections, may need more frequent booster immunizations than normal children.

"Children with HIV infection do not respond to immunizations against common bacteria as well as normal children," said David Goldblatt of The Institute of Child Health and Great Ormond Street Hospital for Children, London, United Kingdom. "In addition, they lose the antibody they do produce more rapidly than healthy children."

Goldblatt spoke during a presentation to the American Society for Microbiology's 36th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), held September 15-18, 1996, in New Orleans, Louisiana.

Goldblatt and colleagues followed a cohort of 48 HIV(+) children and 36 uninfected controls >=18 months of age. All of the children were born to HIV infected women in the U.K. or Italy.

Their initial studies showed that HIV(+) children are less likely than uninfected children to develop protective antibody levels (>1 (micro)g/ml) against Haemophilus influenzae type b (Hib) after vaccination with a Hib/tetanus conjugate vaccine (ACT-HIB, Merieux).

"Following a single dose of Hib conjugate vaccine, 88 percent of HIV infected children had protective antibody levels compared to 100 percent of vaccinated control children one month after immunization," Goldblatt and colleagues found.

But after 12 months of follow up, protection faded in many of the HIV(+) children.

"Not only is the antibody response to Hib-tetanus conjugate vaccine decreased in children with HIV infection and AIDS, but within 12 months of immunization 42 percent of those achieving long-term protective titers initially no longer have them," Goldblatt et al. wrote in their presentation abstract.

"The rate of antibody titer decline was not significantly related to HIV disease status or age-related CD4 count at the time of immunization, or to the change in age-adjusted CD4 count over the year following immunization."

Antibody titers dropped below protective levels in only 11 percent of the normal children.

"Children with HIV infection may therefore require more frequent booster doses of vaccine than the healthy population to maintain protective levels of antibody," the researchers concluded. "Further research is required to define the timing of vaccine boosters and the ability of the vaccine to protect against infection."

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