RESUMEN

BACKGROUND: Pertussis cases have increased worldwide and knowledge on immune response and cytokine profile after Tdap vaccine in immunodeficient adolescents is scarce. OBJECTIVE: To evaluate the immune response after Tdap in HIV-infected (HIV) and in healthy adolescents (CONTROL). METHODOLOGY: Thirty HIV adolescents with CD4 cell counts >200 and 30 CONTROLs were immunized with Tdap, after a prior whole-cell DTP vaccine primary scheme. Blood samples were collected immediately before and after vaccine. Lymphocyte immunophenotyping was performed by flow cytometry; tetanus, diphtheria and pertussis toxin antibodies were assessed by ELISA; whole blood was stimulated with tetanus toxoid and Bordetella pertussis and supernatants were assessed for cytokines by xMAP. RESULTS: Mean age of HIV and CONTROL groups were 17.9 e 17.1 years, respectively. Pain at injection site was more intense in CONTROL group. HIV group had similar increase in tetanus antibodies at 28 days (geometric mean concentration, GMC, 15.6; 95% CI, 7.52-32.4) than CONTROL group (GMC, 23.1; 95% CI, 15.0-35.5), but lower diphtheria antibodies at 28 days (GMC, 2.3; 95% CI, 0.88-6.19) than CONTROL group (GMC, 16.4; 95% CI, 10.3-26.2); for pertussis, the percentage of individuals who seroconverted was lower in HIV than CONTROL group (HIV, 62.1% versus CONTROL, 100%; p = .002). Both groups built a cellular immune response to tetanus, with a Th2 (IL-4, IL-5 and IL-13) and Th1 (IFN-γ) response, with lower cytokine levels in HIV than in CONTROL group. Especially for pertussis, cellular and humoral responses were less intense in HIV adolescents, with a lower Th1 and Th17 profile and higher IL-10 levels. HIV-infected adolescents on viral suppression showed an enhanced immune response to all the three vaccine antigens, although still at lower levels if compared to CONTROL group. CONCLUSIONS: Both groups tolerated well and built an immune response after Tdap. However, HIV-infected adolescents would probably benefit from more frequent booster doses.

Asunto(s)

Anticuerpos Antibacterianos/sangre , Vacuna contra Difteria y Tétanos/uso terapéutico , Vacunas contra Difteria, Tétanos y Tos Ferina Acelular/uso terapéutico , Infecciones por VIH/inmunología , Inmunización Secundaria , Adolescente , Antígenos Bacterianos/inmunología , Niño , Citocinas/inmunología , Difteria/prevención & control , Femenino , Humanos , Inmunidad Celular , Inmunidad Humoral , Transmisión Vertical de Enfermedad Infecciosa , Masculino , Linfocitos T Colaboradores-Inductores/inmunología , Tétanos/prevención & control , Toxoide Tetánico/inmunología , Tos Ferina/prevención & control , Adulto Joven

RESUMEN

Background Pertussis cases have increased worldwide and knowledge on immune response and cytokine profile after Tdap vaccine in immunodeficient adolescents is scarce. Objective To evaluate the immune response after Tdap in HIV-infected (HIV) and in healthy adolescents (CONTROL). Methodology Thirty HIV adolescents with CD4 cell counts?>200 and 30 CONTROLs were immunized with Tdap, after a prior whole-cell DTP vaccine primary scheme. Blood samples were collected immediately before and after vaccine. Lymphocyte immunophenotyping was performed by flow cytometry; tetanus, diphtheria and pertussis toxin antibodies were assessed by ELISA; whole blood was stimulated with tetanus toxoid and Bordetella pertussis and supernatants were assessed for cytokines by xMAP. Results Mean age of HIV and CONTROL groups were 17.9 e 17.1?years, respectively. Pain at injection site was more intense in CONTROL group. HIV group had similar increase in tetanus antibodies at 28?days (geometric mean concentration, GMC, 15.6; 95% CI, 7.52–32.4) than CONTROL group (GMC, 23.1; 95% CI, 15.0–35.5), but lower diphtheria antibodies at 28?days (GMC, 2.3; 95% CI, 0.88–6.19) than CONTROL group (GMC, 16.4; 95% CI, 10.3–26.2); for pertussis, the percentage of individuals who seroconverted was lower in HIV than CONTROL group (HIV, 62.1% versus CONTROL, 100%; p?=?.002). Both groups built a cellular immune response to tetanus, with a Th2 (IL-4, IL-5 and IL-13) and Th1 (IFN-?) response, with lower cytokine levels in HIV than in CONTROL group. Especially for pertussis, cellular and humoral responses were less intense in HIV adolescents, with a lower Th1 and Th17 profile and higher IL-10 levels. HIV-infected adolescents on viral suppression showed an enhanced immune response to all the three vaccine antigens, although still at lower levels if compared to CONTROL group. Conclusions Both groups tolerated well and built an immune response after Tdap. However, HIV-infected adolescents would probably benefit from more frequent booster doses.

RESUMEN

Background Pertussis cases have increased worldwide and knowledge on immune response and cytokine profile after Tdap vaccine in immunodeficient adolescents is scarce. Objective To evaluate the immune response after Tdap in HIV-infected (HIV) and in healthy adolescents (CONTROL). Methodology Thirty HIV adolescents with CD4 cell counts?>200 and 30 CONTROLs were immunized with Tdap, after a prior whole-cell DTP vaccine primary scheme. Blood samples were collected immediately before and after vaccine. Lymphocyte immunophenotyping was performed by flow cytometry; tetanus, diphtheria and pertussis toxin antibodies were assessed by ELISA; whole blood was stimulated with tetanus toxoid and Bordetella pertussis and supernatants were assessed for cytokines by xMAP. Results Mean age of HIV and CONTROL groups were 17.9 e 17.1?years, respectively. Pain at injection site was more intense in CONTROL group. HIV group had similar increase in tetanus antibodies at 28?days (geometric mean concentration, GMC, 15.6; 95% CI, 7.52–32.4) than CONTROL group (GMC, 23.1; 95% CI, 15.0–35.5), but lower diphtheria antibodies at 28?days (GMC, 2.3; 95% CI, 0.88–6.19) than CONTROL group (GMC, 16.4; 95% CI, 10.3–26.2); for pertussis, the percentage of individuals who seroconverted was lower in HIV than CONTROL group (HIV, 62.1% versus CONTROL, 100%; p?=?.002). Both groups built a cellular immune response to tetanus, with a Th2 (IL-4, IL-5 and IL-13) and Th1 (IFN-?) response, with lower cytokine levels in HIV than in CONTROL group. Especially for pertussis, cellular and humoral responses were less intense in HIV adolescents, with a lower Th1 and Th17 profile and higher IL-10 levels. HIV-infected adolescents on viral suppression showed an enhanced immune response to all the three vaccine antigens, although still at lower levels if compared to CONTROL group. Conclusions Both groups tolerated well and built an immune response after Tdap. However, HIV-infected adolescents would probably benefit from more frequent booster doses.

RESUMEN

OBJECTIVE: To evaluate the food intake, anthropometry, body composition, and sexual maturity of children and adolescents with autoimmune hepatitis. METHODS: Thirty-seven children and adolescents with autoimmune hepatitis were studied. A questionnaire was given to evaluate food intake over a 24-hour period. Weight, height, and skin-fold thickness were measured. Electric impedance and skin-fold using Slaughter formula were used to evaluate body composition. Sexual maturity was evaluated using the Tanner stage method. Cumulative intake of corticosteroids was determined based on medical records. RESULTS: Most of the subjects were females (83.3%). Food intake did not meet recommended dietary intakes for energy, calcium, and vitamin A for 43.2%, 94.6%, and 59.4% of the patients, respectively. All subjects were in their respective pubertal developmental stage. A lower Z score for height-for-age (

Asunto(s)

Composición Corporal , Dieta , Hepatitis Autoinmune , Maduración Sexual , Adolescente , Antropometría , Calcio/administración & dosificación , Niño , Estudios Transversales , Ingestión de Alimentos , Impedancia Eléctrica , Ingestión de Energía , Femenino , Estudios de Seguimiento , Glucocorticoides/administración & dosificación , Glucocorticoides/efectos adversos , Glucocorticoides/uso terapéutico , Hepatitis Autoinmune/tratamiento farmacológico , Hepatitis Autoinmune/fisiopatología , Humanos , Masculino , Política Nutricional , Encuestas y Cuestionarios , Vitamina A/administración & dosificación , Adulto Joven