Abstract
ObjectivesTo examine the association between Helicobacter pylori seroprevalence and serum pepsinogens (PGs) as markers of gastric inflammation), with high neutralizing antibody titers to poliovirus type 1 and 3 vaccine strains among children age 3–4 years, subsequent to sub-clinical infection acquired during a wild-type poliovirus type 1 outbreak in Israel.MethodsA serosurvey was conducted among 336 children aged 5–17 years who were vaccinated with both inactivated polio vaccine and oral polio vaccines. H. pylori serum IgG antibodies and PG concentrations were measured using ELISA. Neutralizing antibodies to poliovirus vaccine strains were measured and children with a titer ≥1:8 were considered immune. High-level immunity was defined as having a serum NA titer >1:2048. Propensity score inverse weighting was used to account for confounders.ResultsNeutralizing antibodies titers ≥1:8 to poliovirus type 1 and 3 vaccine strains were found in 99.4 and 98.2% of the children, respectively. An inverse association was found between H. pylori seropositivity accompanied by PGI:PGII ratio ≤6.5 (marker of gastric inflammation) and high-level immunity to poliovirus type 1: OR 0.39 (95% CI 0.68–0.91), p = 0.027. The association between H. pylori seropositivity of CagA virulent phenotype and polio high immunity was not significant. The association between H. pylori seropositivity and high neutralizing antibodies to type 3 poliovirus was of low magnitude and not significant.ConclusionsH. pylori seroprevalence accompanied by evidence of gastric inflammation was inversely correlated with high titers of neutralizing antibodies to poliovirus in children from a population with near universal polio immunity.
Highlights
Polioviruses comprise 3 serotypes that multiply in the human intestine; in a minority of infected persons these can cause paralytic disease, poliomyelitis [1]
We previously showed that infection with H. pylori might affect immune responses to live oral enteric vaccines, such as Vibrio cholerae vaccine CVD 103-HgR [23] and Salmonella Typhi vaccine CVD 908-htrA [24]
We focused on Cytotoxin-associated gene A (CagA) rather than other antigens, given its strong association with gastric pathology, which is well-established than other H. pylori antigens
Summary
Polioviruses comprise 3 serotypes that multiply in the human intestine; in a minority of infected persons these can cause paralytic disease, poliomyelitis [1]. Since the World Health Assembly adopted a resolution for the worldwide eradication of polio in 1988, the number of polio cases worldwide has declined by nearly 99.9%. Both wild poliovirus type 2 (WPV2) and WPV3 have officially been certified as globally eradicated (no cases of WPV2 have been documented since 1999, and none of WPV3 since 2012). Vaccination with OPV induces superior intestinal immunity than IPV; it can prevent the transmission of wild type viruses. Despite these advantages, OPV poses a risk, albeit very low, of vaccine-associated paralytic poliomyelitis (VAPP) [4]. Polio vaccination is based mainly on OPV (with one dose of IPV) in most low-middle income countries, while IPV is mainly used in high-income countries [4]
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