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Infection and Immunity, November 1999, p. 5951-5957, Vol. 67, No. 11
0019-9567/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Human Onchocerciasis and Tetanus Vaccination: Impact on the Postvaccination Antitetanus Antibody Response

Philip J. Cooper,1,* Ivan Espinel,2 Moira Wieseman,1 Wilson Paredes,2 Mauricio Espinel,3 Ronald H. Guderian,2 and Thomas B. Nutman1

Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892,1 and Department of Clinical Investigations, Hospital Vozandes,2 and Ministry of Public Health,3 Quito, Ecuador

Received 28 April 1999/Returned for modification 16 June 1999/Accepted 12 August 1999

To investigate whether helminth infections may affect the efficacy of vaccines by impairing the immune response to nonparasite vaccine antigens, we compared the antibody responses to tetanus toxoid (TT) after tetanus vaccination in 193 subjects with Onchocerca volvulus infection with 85 comparable noninfected controls. After vaccination, the proportions of subjects in each group attaining protective levels of antitetanus antibodies were similar (96.9% infected versus 97.6% noninfected). Postvaccination increases in antitetanus immunoglobulin G (IgG) and the predominant IgG isotype, IgG1, were equivalent in both groups, as were increases in specific IgG4 and IgE; however, significantly greater increases in specific IgG2 (P < 0.05) and IgG3 (P < 0.001) were observed in the noninfected group. Stratification of the O. volvulus-infected group into two groups representing light and heavy infections revealed a significantly impaired antitetanus IgG response in those with heavy infections compared to those with light infections (P < 0.01) or no infection (P < 0.05). The impact of concurrent intestinal helminth infections on the antitetanus response was also examined; an increased IgG4/IgE ratio was seen in those infected with Strongyloides stercoralis (P < 0.05) and when all helminth infections were combined as a single group (P < 0.05). These findings indicate that concurrent infection with O. volvulus does not prevent the development of a protective antitetanus response, although heavier O. volvulus infections are able to alter the magnitude of this response, and concurrent helminth infections (O. volvulus and intestinal helminths) may alter TT-specific antibody isotype responses.

* Corresponding author. Mailing address: Laboratory of Parasitic Diseases, NIAID, Bldg. 4, Rm. 126, National Institutes of Health, 4 Center Dr., Bethesda, MD 20892-0425. Phone: (301) 496-0143. Fax: (301) 480-3757. E-mail: pcooper{at}niaid.nih.gov.

Infection and Immunity, November 1999, p. 5951-5957, Vol. 67, No. 11
0019-9567/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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