Immunogenicity of PCV-10 vaccination in HIV-exposed infants

Infants born to mothers with HIV infection who received the pneumococcal 10-valent conjugate (PCV-10) vaccine during pregnancy had decreased antibody responses and seroprotection against invasive pneumococcal disease compared with infants whose mothers received the pneumococcal 23-valent polysaccharide (PPV-23) vaccine or placebo, according to results of a study published in Clinical Infectious Diseases.

This study analyzed secondary outcomes from a double-blind placebo-controlled randomized trial that assessed pneumococcal vaccination among pregnant women with HIV infection receiving antiretroviral therapy (ART; Clinicaltrials.gov, NCT02717494). Concentrations of serum antibodies for serotypes 4, 7F, 23F, 33F, 1, 5, 6B, and 14 among infants whose mothers received either PCV-10, PPV-23, or placebo were measured at birth, prior to receipt the first and second doses of PCV-10 and after the completion of the 2-dose regimen. Antibody concentrations greater than or equal to 0.35μg/mL were considered seroprotective against invasive pneumococcal disease.

Overall, 347 infants participated in the study. Among the participants’ mothers, 112 received PPV-23, 112 received PCV-10, and 119 received placebo during pregnancy. Among infants born to PCV-10- and PPV-23-immunized mothers, antibody concentrations were similar at birth and at 8 weeks of life, and increased compared with infants whose mothers received placebo. Although infants whose mothers received PCV-10 had significantly decreased antibody concentrations against 5 serotypes after their last dose of PCV-10 compared with those whose mothers received PPV-23, they had decreased antibody concentrations against 3 serotypes compared with those whose mothers received placebo. Seroprotection rates against 7 serotypes were 50% in infants whose mothers received PCV-10 and 71% for infants whose mothers received PPV-23 or placebo (P <.0001).

Study limitations included recruitment from a single region, and some patient populations were underrepresented. It was not verified if the negative effect from maternal PCV-10 immunization persisted at the 1-year booster dose, and T- and B-cell memory responses were not fully evaluated and opsonophagocytic antibodies were not measured.

According to the researchers, “…our results suggest that administration of PPV-23 may be preferable in pregnant women with HIV [infection] on [ART].”

Disclosure: Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures. 

By Bradley van Paridon

Reference

Mussi-Pinhata MM, Ward S, Laimon L, et al. Effect of maternal vaccination of PCV-10, PPV-23 or placebo on the immunogenicity of PCV-10 in HIV-exposed uninfected infants: A randomized clinical trial. Clin Infect Dis. Published online January 7, 2022. doi: 10.1093/cid/ciac026