Effect of Antihelminthic Treatment on Vaccine Immunogenicity to a Seasonal Influenza Vaccine in Primary School Children in Gabon: A Randomized Placebo-Controlled Trial
Creators: name: Brückner, Sina
name: Agnandji, Selidji T.
name: Berberich, Stefan
name: Bache, Emmanuel
name: Fernandes, José F.
name: Schweiger, Brunhilde
name: Loembe, Marguerite Massinga
name: Engleitner, Thomas
name: Lell, Bertrand
name: Mordmüller, Benjamin
name: Adegnika, Ayola A.
name: Yazdanbakhsh, Maria
name: Kremsner, Peter G.
name: Esen, Meral
Publisher: name: Robert Koch-Institut, Infektionskrankheiten / Erreger
Year: 2015
Subjects: subject: Vaccination
subject: Humans
subject: Female
subject: Male
subject: Prevalence
subject: Seasons
subject: Influenza Human/prevention &amp; control
subject: Influenza Human/immunology
subject: Child
subject: Antibodies Viral/blood
subject: Antibodies Viral/immunology
subject: Influenza A Virus H1N1 Subtype/immunology
subject: Influenza Vaccines/immunology
subject: Albendazole/therapeutic use
subject: Anthelmintics/therapeutic use
subject: B-Lymphocytes/immunology
subject: Double-Blind Method
subject: Gabon/epidemiology
subject: Helminthiasis/drug therapy
subject: Helminthiasis/epidemiology
subject: Helminthiasis/immunology
subject: Hemagglutination Inhibition Tests
subject: Immunoglobulin Isotypes/blood
subject: Immunoglobulin Isotypes/classification
subject: Intestinal Diseases Parasitic/drug therapy
subject: Intestinal Diseases Parasitic/epidemiology
subject: Intestinal Diseases Parasitic/immunology
subject: 610 Medizin

description: Background: Helminth infections are a major public health problem, especially in the tropics. Infected individuals have an altered immune response with evidence that antibody response to vaccination is impaired. Hence, treatment of helminth infections before vaccination may be a simple intervention to improve vaccine immunogenicity. In the present study we investigated whether a single-dose antihelminthic treatment influences antibody responses to a seasonal influenza vaccine in primary school children living in Gabon, Central Africa. Methods: In this placebo-controlled double-blind trial conducted in Gabon the effect of a single-dose antihelminthic treatment with 400 mg albendazole versus a placebo one month prior to immunization with a seasonal influenza vaccine was investigated. Antiviral antibody titers against all three vaccine strains were assessed by haemagglutination inhibition (HI) test at baseline (Day 0; vaccination) and four weeks (Day 28) as well as 12 weeks (Day 84) following vaccination. Vaccine-specific memory B-cell response was measured at Day 0 and Day 84 by vaccine-specific Enzyme-linked Immunospot (ELISpot) assay. The trial is registered with the Pan African Clinical Trials Registry (PACTR) (PACTR201303000434188). Results: 98 school children aged 6–10 years were randomly allocated to receive either antihelminthic treatment or placebo and were vaccinated one month after the treatment. The prevalence of helminths at baseline was 21%. Vaccine-specific HI titers against at least one of the three vaccine strains increased at Day 28 and Day 84 in all participants. HI titers against both influenza A strains as well as memory B-cell response were modestly higher in the antihelminthic treated group compared to the placebo group but the difference was not statistically significant. Total but not specific IgA was elevated in the antihelminthic treated group compared to the control group at Day 28. Conclusion: In our setting antihelminthic treatment had no significant effect on influenza vaccine immunogenicity. A trend towards better antiviral and vaccine immunogenicity in the antihelminthic treated group encourages studies to be conducted with alternative treatment schedules or in populations with a higher helminth burden.