Vaccine poliovirus shedding and immune response to oral polio vaccine in HIV-infected and -uninfected Zimbabwean infants

Stephanie B. Troy, Georgina Musingwini, Meira S. Halpern, Chun Hong Huang, Lynda Stranix-Chibanda, Diana Kouiavskaia, Avinash K. Shetty, Konstantin Chumakov, Kusum Nathoo, Yvonne A. Maldonado

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background. With prolonged replication, attenuated polioviruses used in oral polio vaccine (OPV) can mutate into vaccine-derived poliovirus (VDPV) and cause poliomyelitis outbreaks. Individuals with primary humoral immunodeficiencies can become chronically infected with vaccine poliovirus, allowing it to mutate into immunodeficiency-associated VDPV (iVDPV). It is unclear if children perinatally infected with the human immunodeficiency virus (HIV), who have humoral as well as cellular immunodeficiencies, might be sources of iVDPV. Methods. We conducted a prospective study collecting stool and blood samples at multiple time points from Zimbabwean infants receiving OPV according to the national schedule. Nucleic acid extracted from stool was analyzed by real-time polymerase chain reaction for OPV serotypes. Results. We analyzed 825 stool samples: 285 samples from 92 HIV-infected children and 540 from 251 HIV-uninfected children. Poliovirus shedding was similar after 0-2 OPV doses but significantly higher in the HIV-infected versus uninfected children after ≥3 OPV doses, particularly within 42 days of an OPV dose, independent of seroconversion status. HIV infection was not associated with prolonged or persistent poliovirus shedding. HIV infection was associated with significantly lower polio seroconversion rates. Conclusions. HIV infection is associated with decreased mucosal and humoral immune responses to OPV but not the prolonged viral shedding required to form iVDPV.

Original languageEnglish
Pages (from-to)672-678
Number of pages7
JournalJournal of Infectious Diseases
Volume208
Issue number4
DOIs
Publication statusPublished - 15-08-2013
Externally publishedYes

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Poliovirus Vaccines
Poliomyelitis
Vaccines
HIV
Poliovirus
Virus Diseases
Virus Shedding
Mucosal Immunity
Humoral Immunity
Nucleic Acids
Disease Outbreaks
Real-Time Polymerase Chain Reaction
Appointments and Schedules
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Infectious Diseases
  • Immunology and Allergy

Cite this

Troy, S. B., Musingwini, G., Halpern, M. S., Huang, C. H., Stranix-Chibanda, L., Kouiavskaia, D., ... Maldonado, Y. A. (2013). Vaccine poliovirus shedding and immune response to oral polio vaccine in HIV-infected and -uninfected Zimbabwean infants. Journal of Infectious Diseases, 208(4), 672-678. https://doi.org/10.1093/infdis/jit208
Troy, Stephanie B. ; Musingwini, Georgina ; Halpern, Meira S. ; Huang, Chun Hong ; Stranix-Chibanda, Lynda ; Kouiavskaia, Diana ; Shetty, Avinash K. ; Chumakov, Konstantin ; Nathoo, Kusum ; Maldonado, Yvonne A. / Vaccine poliovirus shedding and immune response to oral polio vaccine in HIV-infected and -uninfected Zimbabwean infants. In: Journal of Infectious Diseases. 2013 ; Vol. 208, No. 4. pp. 672-678.
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abstract = "Background. With prolonged replication, attenuated polioviruses used in oral polio vaccine (OPV) can mutate into vaccine-derived poliovirus (VDPV) and cause poliomyelitis outbreaks. Individuals with primary humoral immunodeficiencies can become chronically infected with vaccine poliovirus, allowing it to mutate into immunodeficiency-associated VDPV (iVDPV). It is unclear if children perinatally infected with the human immunodeficiency virus (HIV), who have humoral as well as cellular immunodeficiencies, might be sources of iVDPV. Methods. We conducted a prospective study collecting stool and blood samples at multiple time points from Zimbabwean infants receiving OPV according to the national schedule. Nucleic acid extracted from stool was analyzed by real-time polymerase chain reaction for OPV serotypes. Results. We analyzed 825 stool samples: 285 samples from 92 HIV-infected children and 540 from 251 HIV-uninfected children. Poliovirus shedding was similar after 0-2 OPV doses but significantly higher in the HIV-infected versus uninfected children after ≥3 OPV doses, particularly within 42 days of an OPV dose, independent of seroconversion status. HIV infection was not associated with prolonged or persistent poliovirus shedding. HIV infection was associated with significantly lower polio seroconversion rates. Conclusions. HIV infection is associated with decreased mucosal and humoral immune responses to OPV but not the prolonged viral shedding required to form iVDPV.",
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Troy, SB, Musingwini, G, Halpern, MS, Huang, CH, Stranix-Chibanda, L, Kouiavskaia, D, Shetty, AK, Chumakov, K, Nathoo, K & Maldonado, YA 2013, 'Vaccine poliovirus shedding and immune response to oral polio vaccine in HIV-infected and -uninfected Zimbabwean infants', Journal of Infectious Diseases, vol. 208, no. 4, pp. 672-678. https://doi.org/10.1093/infdis/jit208

Vaccine poliovirus shedding and immune response to oral polio vaccine in HIV-infected and -uninfected Zimbabwean infants. / Troy, Stephanie B.; Musingwini, Georgina; Halpern, Meira S.; Huang, Chun Hong; Stranix-Chibanda, Lynda; Kouiavskaia, Diana; Shetty, Avinash K.; Chumakov, Konstantin; Nathoo, Kusum; Maldonado, Yvonne A.

In: Journal of Infectious Diseases, Vol. 208, No. 4, 15.08.2013, p. 672-678.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Vaccine poliovirus shedding and immune response to oral polio vaccine in HIV-infected and -uninfected Zimbabwean infants

AU - Troy, Stephanie B.

AU - Musingwini, Georgina

AU - Halpern, Meira S.

AU - Huang, Chun Hong

AU - Stranix-Chibanda, Lynda

AU - Kouiavskaia, Diana

AU - Shetty, Avinash K.

AU - Chumakov, Konstantin

AU - Nathoo, Kusum

AU - Maldonado, Yvonne A.

PY - 2013/8/15

Y1 - 2013/8/15

N2 - Background. With prolonged replication, attenuated polioviruses used in oral polio vaccine (OPV) can mutate into vaccine-derived poliovirus (VDPV) and cause poliomyelitis outbreaks. Individuals with primary humoral immunodeficiencies can become chronically infected with vaccine poliovirus, allowing it to mutate into immunodeficiency-associated VDPV (iVDPV). It is unclear if children perinatally infected with the human immunodeficiency virus (HIV), who have humoral as well as cellular immunodeficiencies, might be sources of iVDPV. Methods. We conducted a prospective study collecting stool and blood samples at multiple time points from Zimbabwean infants receiving OPV according to the national schedule. Nucleic acid extracted from stool was analyzed by real-time polymerase chain reaction for OPV serotypes. Results. We analyzed 825 stool samples: 285 samples from 92 HIV-infected children and 540 from 251 HIV-uninfected children. Poliovirus shedding was similar after 0-2 OPV doses but significantly higher in the HIV-infected versus uninfected children after ≥3 OPV doses, particularly within 42 days of an OPV dose, independent of seroconversion status. HIV infection was not associated with prolonged or persistent poliovirus shedding. HIV infection was associated with significantly lower polio seroconversion rates. Conclusions. HIV infection is associated with decreased mucosal and humoral immune responses to OPV but not the prolonged viral shedding required to form iVDPV.

AB - Background. With prolonged replication, attenuated polioviruses used in oral polio vaccine (OPV) can mutate into vaccine-derived poliovirus (VDPV) and cause poliomyelitis outbreaks. Individuals with primary humoral immunodeficiencies can become chronically infected with vaccine poliovirus, allowing it to mutate into immunodeficiency-associated VDPV (iVDPV). It is unclear if children perinatally infected with the human immunodeficiency virus (HIV), who have humoral as well as cellular immunodeficiencies, might be sources of iVDPV. Methods. We conducted a prospective study collecting stool and blood samples at multiple time points from Zimbabwean infants receiving OPV according to the national schedule. Nucleic acid extracted from stool was analyzed by real-time polymerase chain reaction for OPV serotypes. Results. We analyzed 825 stool samples: 285 samples from 92 HIV-infected children and 540 from 251 HIV-uninfected children. Poliovirus shedding was similar after 0-2 OPV doses but significantly higher in the HIV-infected versus uninfected children after ≥3 OPV doses, particularly within 42 days of an OPV dose, independent of seroconversion status. HIV infection was not associated with prolonged or persistent poliovirus shedding. HIV infection was associated with significantly lower polio seroconversion rates. Conclusions. HIV infection is associated with decreased mucosal and humoral immune responses to OPV but not the prolonged viral shedding required to form iVDPV.

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