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Body Mass Index and Vaccine-induced Immune Responses in Children Living With HIV
Jacob D Massa1, Mark J Giganti2, Jane C Lindsey2
1From the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Insights
Children living with HIV and obesity show a link to hepatitis B vaccine response. Other vaccines studied appear adequate for this population, regardless of body mass index z-score (BMIz).
Area of Science:
- Pediatric Immunology
- Infectious Diseases
- Vaccinology
Background:
- Rising obesity rates in children with HIV, influenced by antiretroviral therapy and environment.
- Obesity and HIV can independently cause immune dysregulation.
- Potential combined negative impact on vaccine response in children with HIV.
Purpose of the Study:
- To investigate the association between body mass index z-score (BMIz) and vaccine-induced antibody concentrations.
- To assess the impact of BMIz on immune response to hepatitis A, hepatitis B, and pneumococcal vaccines in children with HIV.
Main Methods:
- Analysis of data from clinical trials of three vaccines in children with HIV.
- Utilized adjusted linear regression for interval-censored data and logistic regression models.
- Assessed BMIz associations with antibody response up to 104 weeks post-vaccination.
Main Results:
- BMIz was significantly associated with hepatitis B antibody concentration 8 weeks post-vaccination (P=0.026).
- Highest seroconversion probability (47%) for hepatitis B vaccine observed at BMIz near 1.
- No significant association found between BMIz and antibody response for hepatitis A or pneumococcal vaccines.
Conclusions:
- Hepatitis A, hepatitis B, and pneumococcal vaccines are likely adequate and protective.
- Current vaccine administration appears effective across a broad range of BMI in children with HIV.
- Further research may explore nuanced effects of BMIz on specific vaccine responses.
Background:
Children living with HIV are experiencing rising rates of obesity, driven by both the side effects of antiretroviral therapy and the increasingly obesogenic environments. Obesity and HIV are both known to cause immune dysregulation, which may have a combined negative effect on vaccine-induced immune response in this vulnerable population. This study aimed to determine whether body mass index z-score (BMIz) is associated with vaccine-induced antibody concentrations in children living with HIV.
Methods:
This study used data from clinical trials for 3 separate vaccines (hepatitis A, hepatitis B and pneumococcal [conjugate plus polysaccharide]) administered to children living with HIV. Enrollment was between September 1999 and March 2003 in the United States. Adjusted linear regression for interval-censored data and logistic regression models were used to assess associations for BMIz with antibody response up to 104 weeks after vaccine administration.
Results:
Participant age ranged from 2 to 20 years old. Analyses included 150 participants for the hepatitis A vaccine, 154 for the hepatitis B vaccine and 214 for the pneumococcal vaccine. BMIz was associated with hepatitis B antibody concentration 8 weeks after vaccination ( P = 0.026) with the highest probability (47%) of seroconversion for participants with BMIz near 1. There was no statistically significant association between BMIz and antibody response for the hepatitis A vaccine or 4 of 5 studied serotypes in the pneumococcal vaccine (n = 214).
Conclusions:
The hepatitis A, hepatitis B and pneumococcal vaccines are likely adequate as administered and protective for children living with HIV at a broad range of BMI.
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