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Impact of enterovirus and other enteric pathogens on oral polio and rotavirus vaccine performance in Bangladeshi infants

Wednesday, 8th of June 2016

Vaccine. 2016 May 3. pii: S0264-410X(16)30254-7. doi: 10.1016/j.vaccine.2016.04.080. [Epub ahead of print]

Impact of enterovirus and other enteric pathogens on oral polio and rotavirus vaccine performance in Bangladeshi infants

Taniuchi M1, Platts-Mills JA2, Begum S3, Uddin MJ3, Sobuz SU3, Liu J2, Kirkpatrick BD4, Colgate ER4, Carmolli MP4, Dickson DM4, Nayak U5, Haque R3, Petri WA Jr2, Houpt ER2.

Author information

1Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville 22908, USA. Electronic address: mt2f@virginia.edu.

2Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville 22908, USA.

3Center for Vaccine Science and Parasitology Lab, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka 1212, Bangladesh.

4Vaccine Testing Center and Unit of Infectious Diseases, Department of Medicine, University of Vermont College of Medicine, Burlington, VT 05405, USA.

5Center for Public Health Genomics, University of Virginia, Charlottesville 22908, USA.

Abstract below; full text is at http://www.sciencedirect.com/science/article/pii/S0264410X16302547

BACKGROUND:

Oral polio vaccine (OPV) and rotavirus vaccine (RV) exhibit poorer performance in low-income settings compared to high-income settings. Prior studies have suggested an inhibitory effect of concurrent non-polio enterovirus (NPEV) infection, but the impact of other enteric infections has not been comprehensively evaluated.

METHODS:

In urban Bangladesh, we tested stools for a broad range of enteric viruses, bacteria, parasites, and fungi by quantitative PCR from infants at weeks 6 and 10 of life, coincident with the first OPV and RV administration respectively, and examined the association between enteropathogen quantity and subsequent OPV serum neutralizing titers, serum rotavirus IgA, and rotavirus diarrhea.

RESULTS:

Campylobacter and enterovirus (EV) quantity at the time of administration of the first dose of OPV was associated with lower OPV1-2 serum neutralizing titers, while enterovirus quantity was also associated with diminished rotavirus IgA (-0.08 change in log titer per tenfold increase in quantity; P=0.037), failure to seroconvert (OR 0.78, 95% CI: 0.64-0.96; P=0.022), and breakthrough rotavirus diarrhea (OR 1.34, 95% CI: 1.05-1.71; P=0.020) after adjusting for potential confounders. These associations were not observed for Sabin strain poliovirus quantity.

CONCLUSION:

In this broad survey of enteropathogens and oral vaccine performance we find a particular association between EV carriage, particularly NPEV, and OPV immunogenicity and RV protection. Strategies to reduce EV infections may improve oral vaccine responses. ClinicalTrials.gov Identifier: NCT01375647.

Copyright © 2016. Published by Elsevier Ltd.