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Low Rates of Poliovirus Antibodies in Primary Immunodeficiency Patients on Regular Intravenous Immunoglobulin Treatment

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Abstract

Purpose

Poliovirus has been nearly eliminated as part of a world-wide effort to immunize and contain circulating wild-type polio. Nevertheless, poliovirus has been detected in water supplies and represents a threat to patients with humoral immunodeficiencies where infection can be fatal. To define the risk, we analyzed antibodies to poliovirus 1, 2, and 3 in serum samples collected over a year from patients with primary immunodeficiency diseases (PID) on regular intravenous immunoglobulin (IVIG) replacement.

Methods

Twenty-one patients on regular IVIG replacement therapy were evaluated: Twelve patients with common variable immune deficiency (CVID), six with X-linked agammaglobulinemia (XLA), and three with hyper IgM syndrome (HIGM). Over 1 year, four blood samples were collected from each of these patients immediately before immunoglobulin infusion. One sample of IVIG administered to each patient in the month before blood collection was also evaluated. Poliovirus antibodies were quantified by seroneutralization assay.

Results

All IVIG samples had detectable antibodies to the three poliovirus serotypes. Despite that, only 52.4, 61.9, and 19.0% of patients showed protective antibody titers for poliovirus 1, 2, and 3, respectively. Only two patients (9.5%) had protective antibodies for the three poliovirus serotypes on all samples. Most patients were therefore susceptible to all three poliovirus serotypes.

Conclusions

This study demonstrates the need for ongoing vigilance regarding exposure of patients with PID to poliovirus in the community.

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Financial Support

This study was funded by the FAPESP (2011/06136-6), a Brazilian Funding Agency.

Author information

Authors and Affiliations

  1. Division of Allergy Clinical Immunology and Rheumatology, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil

    Beatriz T. Costa-Carvalho, Patrícia M. Fontes, Fernanda Aimé-Nobre & Isabela G. S. Gonzales

  2. Division of Allergy Immunology, The Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Kathleen E. Sullivan

  3. Division of Pediatric Infectious Diseases, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil

    Patrícia M. Fontes & Maria Isabel de Moraes-Pinto

  4. Division of Infectious Diseases, Department of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil

    Elaine S. Lima & Celso Granato

  5. Research Laboratory, Division of Pediatric Infectious Diseases, Federal University of Sao Paulo, Rua Pedro de Toledo, 781/9°andar, São Paulo, SP, 04039-032, Brazil

    Maria Isabel de Moraes-Pinto

Author notes

  1. Patrícia M. Fontes is deceased. This paper is dedicated to her memory.

    • Patrícia M. Fontes
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  1. Beatriz T. Costa-Carvalho
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Correspondence to Maria Isabel de Moraes-Pinto.

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The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Costa-Carvalho, B.T., Sullivan, K.E., Fontes, P.M. et al. Low Rates of Poliovirus Antibodies in Primary Immunodeficiency Patients on Regular Intravenous Immunoglobulin Treatment. J Clin Immunol 38, 628–634 (2018). https://doi.org/10.1007/s10875-018-0531-x

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  • DOI: https://doi.org/10.1007/s10875-018-0531-x

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