Abstract | BACKGROUND: Haemophilus influenzae type b (Hib) conjugate vaccines have successfully reduced the burden of invasive Hib disease in developed countries; however, their effectiveness in countries with a high incidence of pediatric HIV-1 is unknown. METHODS: The effectiveness of Hib conjugate vaccine was prospectively evaluated in South African children. The burden of invasive Hib disease in children < 1 year old was compared in 2 cohorts. The first cohort included 22,000 African children born in 1997 [969 (4.45%) of whom were estimated to be HIV-1-infected] who were not vaccinated with Hib conjugate vaccine. This group was compared with 19,267 children [1162 (6.03%) of whom were estimated to be HIV-1 infected] vaccinated at 6, 10 and 14 weeks of age with an Hib conjugate vaccine [ TETRAMUNE (polyribosylribitol phosphate- CRM(197)- diphtheria- tetanus toxoids-whole cell pertussis)] between March, 1998, and June, 1999. RESULTS: The estimated burden of invasive Hib disease in nonimmunized HIV-1-infected children < 1 year of age was 5.9-fold [95% confidence interval (95% CI), 2.7 to 12.6] higher than in HIV-1-uninfected children. The overall estimated effectiveness of Hib conjugate vaccine in fully vaccinated children <1 year of age was 83.2% (95% CI 60.3 to 92.9). Vaccine effectiveness was significantly reduced in HIV-1-infected [43.9% (95% CI -76.1 to 82.1)] compared with uninfected children [96.5% (95% CI 74.4 to 99.5); P < 10(-5)]. Among three of the fully vaccinated HIV-1-infected children who developed invasive Hib disease, the anti-Hib polyribosylribitol phosphate serum antibody concentrations were 0.23, 0.25 and 0.68 microg/ml. CONCLUSION: Although the Hib conjugate vaccine was less effective among HIV-1-infected than among uninfected children, it was 83% effective in preventing overall invasive Hib disease and therefore should be considered for inclusion in the routine vaccination schedule by other African countries.
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Authors | Shabir A Madhi, Karen Petersen, Manikant Khoosal, Robin E Huebner, Nontombi Mbelle, Rosalia Mothupi, Haroon Saloojee, Heather Crewe-Brown, Keith P Klugman |
Journal | The Pediatric infectious disease journal
(Pediatr Infect Dis J)
Vol. 21
Issue 4
Pg. 315-21
(Apr 2002)
ISSN: 0891-3668 [Print] United States |
PMID | 12075763
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Antibody Formation
- Cohort Studies
- Female
- HIV Infections
(complications, immunology)
- HIV-1
(pathogenicity)
- Haemophilus Infections
(epidemiology, prevention & control, virology)
- Haemophilus Vaccines
(immunology, pharmacology)
- Haemophilus influenzae type b
(immunology, pathogenicity)
- Humans
- Infant
- Infant, Newborn
- Male
- Prevalence
- Prospective Studies
- South Africa
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