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Impaired antibody memory to varicella zoster virus in HIV‐infected children: low antibody levels and avidity *
Author(s) -
L'Huillier AG,
Ferry T,
Courvoisier DS,
Aebi C,
Cheseaux JJ,
Kind C,
Rudin C,
Nadal D,
Hirschel B,
Sottas C,
Siegrist CA,
PosfayBarbe KM
Publication year - 2012
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2011.00936.x
Subject(s) - medicine , avidity , antibody , immunology , varicella zoster virus , virology , virus , odds ratio , immunoglobulin g , confidence interval
ObjectiveHIV‐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.MethodsIn 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.ResultsMedian anti‐VZV immunoglobulin G (IgG) levels were lower in HIV‐infected children than in adults (264 vs . 1535 IU/L; P <0.001) and levels became more frequently unprotective over time in the children [odds ratio (OR) 17.74; 95% confidence interval (CI) 4.36–72.25; P <0.001]. 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; P <0.001). Antibody avidity was lower in HIV‐infected than healthy children ( P <0.001). A direct correlation between anti‐VZV IgG level and avidity was present in HIV‐infected children ( P =0.001), but not in healthy children.ConclusionFailure 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.