In fl uence of Enteric Infections on Response to Oral Poliovirus Vaccine : A Systematic Review and Meta-analysis

Background. The impaired immunogenicity of oral poliovirus vaccine (OPV) in low-income countries has been apparent since the early field trials of this vaccine. Infection with enteropathogens at the time of vaccination may contribute to this phenomenon. However, the relative influence of these infections on OPV performance remains uncertain. Methods. We conducted a systematic review to examine the impact of concurrent enteric infections on OPV response. Using random-effects models, we assessed the effects of nonpolio enteroviruses (NPEVs) and diarrhea on the odds of seroconversion and/or vaccine virus shedding. Results. We identified 25 trials in which OPV outcomes were compared according to the presence or absence of enteric infections, the majority of which (n = 17) reported only on NPEVs. Concurrent NPEVs significantly reduced the odds of per-dose seroconversion for type 1 poliovirus (odds ratio [OR] 0.44, 95% confidence interval 0.23−0.84), but not type 2 (OR 0.53 [0.19−1.46]) or type 3 (OR 0.56 [0.27−1.12]). A similar reduction, significant for type 1 poliovirus (OR 0.50 [0.28−0.89]), was observed in the odds of vaccine virus shedding among NPEV-infected individuals. Concurrent diarrhea significantly inhibited per-dose seroconversion overall (OR 0.61 [0.38−0.87]). Conclusions. Our findings are consistent with an inhibitory effect of concurrent enteric infections on OPV response.

[1]  J. Qazi,et al.  From Pakistan a line of hope for ‘The Polio Eradication and Endgame Strategic Plan 2013–2018’ , 2016, Infectious diseases.

[2]  Mike W-L Cheung,et al.  Modeling dependent effect sizes with three-level meta-analyses: a structural equation modeling approach. , 2014, Psychological methods.

[3]  Inacio Mandomando,et al.  Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study , 2013, The Lancet.

[4]  W. Petri,et al.  Environmental enteropathy: critical implications of a poorly understood condition. , 2012, Trends in molecular medicine.

[5]  M. Bhan,et al.  Improving the performance of enteric vaccines in the developing world , 2010, Nature Immunology.

[6]  S. Madhi,et al.  Effect of human rotavirus vaccine on severe diarrhea in African infants. , 2010, The New England journal of medicine.

[7]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement , 2009, BMJ.

[8]  Claire Blanchard,et al.  Recombination between Polioviruses and Co-Circulating Coxsackie A Viruses: Role in the Emergence of Pathogenic Vaccine-Derived Polioviruses , 2009, PLoS pathogens.

[9]  G. Smith,et al.  Bias in meta-analysis detected by a simple, graphical test , 1997, BMJ.

[10]  K. Dellagi,et al.  Influence of host related factors on the antibody response to trivalent oral polio vaccine in Tunisian infants. , 1997, Vaccine.

[11]  S. Matsui,et al.  Host and Viral Factors Affecting the Decreased Immunogenicity of Sabin Type 3 Vaccine after Administration of Trivalent Oral Polio Vaccine to Rural Mayan Children , 1997, The Journal of infectious diseases.

[12]  R. Linkins,et al.  The effect of diarrhea on oral poliovirus vaccine failure in Brazil. , 1997, The Journal of infectious diseases.

[13]  J. Modlin,et al.  Effect of diarrhea on the humoral response to oral polio vaccination. , 1996, The Pediatric infectious disease journal.

[14]  L. Duffy,et al.  Effect of concurrent viral infection on systemic and local antibody responses to live attenuated and enhanced-potency inactivated poliovirus vaccines. , 1992, American journal of diseases of children.

[15]  M. Levine,et al.  Safety and immunogenicity of different immunization regimens of CVD 103-HgR live oral cholera vaccine in soldiers and civilians in Thailand. , 1992, The Journal of infectious diseases.

[16]  P. Wright,et al.  Factors affecting the immunogenicity of oral poliovirus vaccine in developing countries: review. , 1991, Reviews of infectious diseases.

[17]  N. Laird,et al.  Meta-analysis in clinical trials. , 1986, Controlled clinical trials.

[18]  T. John,et al.  Oral polio vaccination of children in the tropics. III. Intercurrent enterovirus infections, vaccine virus take and antibody response. , 1975, American journal of epidemiology.

[19]  T. Swartz,et al.  Routine administration of oral polio vaccine in a subtropical area. Factors possibly influencing sero-conversion rates , 1972, Epidemiology and Infection.

[20]  L. Kartman.  FIRST INTERNATIONAL CONFERENCE ON VACCINES AGAINST VIRAL AND RICKETTSIAL DISEASES OF MAN , 1968 .

[21]  L. Dardanoni,et al.  [Studies on circulation of enterovirus in samples of the population subjected to oral antipoliomyelitis vaccination]. , 1965, Rivista dell'Istituto sieroterapico italiano.

[22]  S. Urasawa.  [Studies on the interference between group B coxsackie viruses and polioviruses. 2. Comparisons of the effects of coxsackie B 5 virus on the immunizations with mono- and polyvalent live poliovirus vaccines]. , 1964, Sapporo igaku zasshi. The Sapporo medical journal.

[23]  S. Urasawa.  [Studies on the interference between group B coxsackie viruses and polioviruses. I. The interference with attenuated polioviruses by coxsackie B5 virus in man]. , 1964, Sapporo igaku zasshi. The Sapporo medical journal.

[24]  L. Dardanoni,et al.  [Recent research on the take of attenuated poliomyelitis virus (type I, Sabin LSc strain) in children living in a community with a high level of enteroviral infections]. , 1962, Rivista dell'Istituto sieroterapico italiano.

[25]  R. Warren,et al.  BEHAVIOR OF SABIN TYPE 1 ATTENUATED POLIOVIRUS IN AN INFANT POPULATION INFECTED WITH ECHO 14 VIRUS , 1962, Pediatrics.

[26]  I. Dömök,et al.  Virus Excretion after Mass Vaccination with Attenuated Polioviruses in Hungary , 1961, British medical journal.

[27]  A. Sabin,et al.  Community-wide use of oral poliovirus vaccine. Efectiveness of the Cincinnati program. , 1961, American journal of diseases of children.

[28]  A. Sabin,et al.  Live, orally given poliovirus vaccine. Effects of rapid mass immunization on population under conditions of massive enteric infection with other viruses. , 1960 .

[29]  P. Tukei,et al.  Serological and virological assessment of oral and inactivated poliovirus vaccines in a rural population in Kenya. , 1992, Bulletin of the World Health Organization.

[30]  I. Imam,et al.  The influence of bacillary dysentery on the efficiency of oral poliovaccine in Egypt. , 1976, The Gazette of the Egyptian Paediatric Association.

[31]  T. Swartz,et al.  Non-polio virus interference with oral polio vaccine immunization: possible influence of physical climate and socio-economic status. , 1972, Advances in Experimental Medicine and Biology.

[32]  Epidemiology Subcommittee.  Evaluation of Sabin live poliovirus vaccine in Japan. II. Clinical, virologic and immunologic effects of vaccine in children. , 1966, Japanese journal of medical science & biology.

[33]  P. Sureau,et al.  Second campaign of oral vaccination against poliomyelitis in Laghouat, Algeria in 1966. 2. Virological and serological response to vaccination. , 1966 .

[34]  G. Nardi,et al.  Oral revaccination against poliomyelitis and interference. , 1966 .

[35]  C. A. Phillips,et al.  Enteric virus isolation in different cell cultures. , 1965, Bulletin of the World Health Organization.

[36]  E. Opton,et al.  An oral poliovirus vaccine trial in Costa Rica. , 1962, Bulletin of the World Health Organization.

[37]  S. G. Drozdov,et al.  Interaction of viruses in the intestinal tract of man. I. Interference between wild and vaccine poliovirus strains. , 1961, Acta virologica.

[38]  M. Ramos‐Álvarez.  [Use of the live Sabin poliomyelitis vaccine in Mexico. Preliminary basic studies]. , 1961, Boletín Médico del Hospital Infantil de México.

[39]  S. Plotkin,et al.  Vaccination with the CHAT strain of type 1 attenuated poliomyelitis virus in Leopoldville. Belgian Congo. 2. Studies of the safety and efficacy of vaccination. , 1960, Bulletin of the World Health Organization.