{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T14:26:02Z","timestamp":1780410362069,"version":"3.54.1"},"reference-count":40,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T00:00:00Z","timestamp":1755302400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background: Despite virological suppression through antiretroviral therapy (ART), people living with HIV (PLHIV) may exhibit inadequate immune responses to vaccination, placing them at continued risk for preventable infectious diseases. Evidence regarding the durability of vaccine-induced immunity in PLHIV with vertically acquired infection remains limited. Methods: We conducted a cross-sectional observational study to evaluate humoral immunity to routine childhood vaccines in a cohort of PLHIV with perinatally acquired infection. Antibody titers against diphtheria, tetanus, measles, mumps, rubella, varicella, and hepatitis B (HBV) were retrospectively assessed via serological testing and review of medical records. Seroprotection rates were analyzed at predefined intervals following the completion of the primary immunization schedule. Multivariate analysis was used to explore potential predictors of long-term immune response. Results: A total of 85 individuals were included. Two years after completing the primary vaccination series, seroprotection rates were as follows: diphtheria 71%, tetanus 79%, measles 79%, mumps 67%, rubella 87%, and varicella 54%. Five years post-vaccination, 50\u201370% of participants maintained protective antibody levels, declining further to 50\u201358% after ten years. By twenty years, protective immunity dropped below 30% for all antigens except rubella (47%). HBV vaccine responses were notably poor, with only 60%, 37%, 24%, and 7.5% retaining protective anti-HBs titers at 2, 5, 10, and 20 years post-immunization, respectively. Time elapsed since vaccination was the sole significant predictor of seroprotection across all vaccines. Conclusions: In this cohort of vertically infected PLHIV, vaccine-induced immunity was suboptimal and declined markedly over time compared to the general population. These findings highlight the need for tailored immunization strategies, including timely boosters and regular serological monitoring, to maintain long-term protection in this high-risk group.<\/jats:p>","DOI":"10.3390\/vaccines13080871","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T16:22:33Z","timestamp":1755534153000},"page":"871","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Immune Response to Childhood Vaccination in Vertically Infected People Living with HIV: A Long-Term Evaluation"],"prefix":"10.3390","volume":"13","author":[{"given":"Annachiara","family":"Zin","sequence":"first","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Department of Women\u2019s and Children\u2019s Health, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0850-8784","authenticated-orcid":false,"given":"Elisa","family":"Barbieri","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Department of Women\u2019s and Children\u2019s Health, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Brigadoi","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Department of Women\u2019s and Children\u2019s Health, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Berlese","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Department of Women\u2019s and Children\u2019s Health, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Chiusaroli","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Department of Women\u2019s and Children\u2019s Health, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1374-1505","authenticated-orcid":false,"given":"Daniele","family":"Mengato","sequence":"additional","affiliation":[{"name":"Hospital Pharmacy Department, University Hospital of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Francavilla","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Giaquinto","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Department of Women\u2019s and Children\u2019s Health, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7105-2105","authenticated-orcid":false,"given":"Daniele","family":"Don\u00e0","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Department of Women\u2019s and Children\u2019s Health, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osvalda","family":"Rampon","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Department of Women\u2019s and Children\u2019s Health, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,16]]},"reference":[{"key":"ref_1","unstructured":"(2024, June 28). WHO Epidemiological Fact Sheet, HIV Statistic, Globally and by WHO Region. Available online: https:\/\/cdn.who.int\/media\/docs\/default-source\/hq-hiv-hepatitis-and-stis-library\/j0294-who-hiv-epi-factsheet-v7.pdf."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e295","DOI":"10.1016\/S2352-3018(23)00028-0","article-title":"Life Expectancy after 2015 of Adults with HIV on Long-Term Antiretroviral Therapy in Europe and North America: A Collaborative Analysis of Cohort Studies","volume":"10","author":"Trickey","year":"2023","journal-title":"Lancet HIV"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"22789","DOI":"10.3402\/gha.v7.22789","article-title":"How Have ART Treatment Programmes Changed the Patterns of Excess Mortality in People Living with HIV? Estimates from Four Countries in East and Southern Africa","volume":"7","author":"Slaymaker","year":"2014","journal-title":"Glob. Health Action"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1111\/j.1468-1293.2011.00982.x","article-title":"Guidance on Vaccination of HIV-Infected Children in Europe","volume":"13","author":"Menson","year":"2012","journal-title":"HIV Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/01.inf.0000437856.09540.11","article-title":"Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children: Recommendations from the National Institutes of Health, Centers for Disease Control and Prevention, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics","volume":"32","author":"Siberry","year":"2013","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Cheng, Z., Lin, P., and Cheng, N. (2021). HBV\/HIV Coinfection: Impact on the Development and Clinical Treatment of Liver Diseases. Front. Med., 8.","DOI":"10.3389\/fmed.2021.713981"},{"key":"ref_7","unstructured":"Irina, E., Srdan, M., and Monique, M. (2025, August 15). HIV\/AIDS treatment and care: Clinical protocols for the WHO European Region. World Health Organization. Regional Office for Europe. Available online: https:\/\/iris.who.int\/handle\/10665\/341846."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1093\/cid\/cit816","article-title":"2013 IDSA Clinical Practice Guideline for Vaccination of the Immunocompromised Host","volume":"58","author":"Rubin","year":"2014","journal-title":"Clin. Infect. Dis."},{"key":"ref_9","unstructured":"Toti, M., Carosi, G., Consiglieri, A.P., Alberici, F., Azzini, M., Cargnel, A., Monforte, A., De Lalla, F., De, F., and Esposito, R.R. (2010). Linee Guida Italiane Sull\u2019utilizzo Della Terapia Antiretrovirale e la Gestione Diagnostico-Clinica Delle Persone con Infezione da HIV-1, Ministero della Salute."},{"key":"ref_10","unstructured":"Pozniak, A., Hospital, W., and Alison Rodger, L. (2015). British HIV Association Guidelines on the Use of Vaccines in HIV-Positive Adults 2015 Bhiva Guidelines on the Use of Vaccines in HIV\u2014Positive Adults 2015 Writing Group, British HIV Association (BHIVA)."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/S1473-3099(10)70116-X","article-title":"Do Children Infected with HIV Receiving HAART Need to Be Revaccinated?","volume":"10","author":"Sutcliffe","year":"2010","journal-title":"Lancet Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1093\/cid\/cit937","article-title":"Long-Term Immune Responses to Vaccination in HIV-Infected Patients: A Systematic Review and Meta-Analysis","volume":"58","author":"Launay","year":"2014","journal-title":"Clin. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1542\/peds.2005-2616","article-title":"Persistent Humoral Immune Defect in Highly Active Antiretroviral Therapy-Treated Children with HIV-1 Infection: Loss of Specific Antibodies against Attenuated Vaccine Strains and Natural Viral Infection","volume":"118","author":"Bekker","year":"2006","journal-title":"Pediatrics"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1097\/INF.0b013e3181903ed3","article-title":"Immune Responses to Measles and Tetanus Vaccines among Kenyan Human Immunodeficiency Virus Type 1 (HIV-1)-Infected Children Pre- and Post-Highly Active Antiretroviral Therapy and Revaccination","volume":"28","author":"Farquhar","year":"2009","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1542\/peds.111.6.e641","article-title":"Response to Immunization with Measles, Tetanus, and Haemophilus Influenzae Type b Vaccines in Children Who Have Human Immunodeficiency Virus Type 1 Infection and are Treated with Highly Active Antiretroviral Therapy","volume":"111","author":"Melvin","year":"2003","journal-title":"Pediatrics"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Bruzzese, E., Pagano, F., Diana, A., Punzi, L., and Guarino, A. (2021). Protection of Vaccine Preventable Diseases in a Population of Hiv-Infected Children: A 3 Years Prospective Study. Vaccines, 9.","DOI":"10.3390\/vaccines9111331"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1784","DOI":"10.4161\/hv.21827","article-title":"Immune Reconstitution and Vaccination Outcome in HIV-1 Infected Children: Present Knowledge and Future Directions","volume":"8","author":"Cagigi","year":"2012","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"7939","DOI":"10.1073\/pnas.0901702106","article-title":"Timing of HAART Defines the Integrity of Memory B Cells and the Longevity of Humoral Responses in HIV-1 Vertically-Infected Children","volume":"106","author":"Pensieroso","year":"2009","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies","volume":"61","author":"Altman","year":"2008","journal-title":"J. Clin. Epidemiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"6","DOI":"10.15585\/mmwr.mm7301a2","article-title":"Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger-United States, 2024","volume":"73","author":"Wodi","year":"2024","journal-title":"MMWR Morb. Mortal Wkly. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2594","DOI":"10.1016\/j.vaccine.2015.03.104","article-title":"Immunogenicity and Reactogenicity of a Decennial Booster Dose of a Combined Reduced-Antigen-Content Diphtheria-Tetanus-Acellular Pertussis and Inactivated Poliovirus Booster Vaccine (DTpa-IPV) in Healthy Adults","volume":"33","author":"Kovac","year":"2015","journal-title":"Vaccine"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2647","DOI":"10.1016\/j.vaccine.2012.02.013","article-title":"Humoral Immunity 10 Years after Booster Immunization with an Adolescent and Adult Formulation Combined Tetanus, Diphtheria, and 5-Component Acellular Pertussis Vaccine","volume":"30","author":"Tomovici","year":"2012","journal-title":"Vaccine"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"660","DOI":"10.7326\/0003-4819-136-9-200205070-00008","article-title":"Serologic Immunity to Diphtheria and Tetanus in the United States Background: Serologic Data on Diseases That Are Preventable By","volume":"136","author":"Mcquillan","year":"2002","journal-title":"Ann. Intern. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"6325","DOI":"10.1016\/j.vaccine.2018.08.051","article-title":"Antibody Persistence and Safety and Immunogenicity of a Second Booster Dose Nine Years after a First Booster Vaccination with a Reduced Antigen Diphtheria-Tetanus-Acellular Pertussis Vaccine (Tdap) in Adults","volume":"36","author":"Brandon","year":"2018","journal-title":"Vaccine"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Coppola, N., Corvino, A.R., De Pascalis, S., Signoriello, G., Di Fiore, E., Nienhaus, A., Sagnelli, E., and Lamberti, M. (2015). The Long-Term Immunogenicity of Recombinant Hepatitis B Virus (HBV) Vaccine: Contribution of Universal HBV Vaccination in Italy. BMC Infect. Dis., 15.","DOI":"10.1186\/s12879-015-0874-3"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1093\/cid\/ciu867","article-title":"Durability of Antibody Response against Hepatitis B Virus in Healthcare Workers Vaccinated as Adults","volume":"60","author":"Gara","year":"2015","journal-title":"Clin. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"5323","DOI":"10.1016\/j.vaccine.2019.07.049","article-title":"Long-Term Immunogenicity of Measles, Mumps and Rubella-Containing Vaccines in Healthy Young Children: A 10-Year Follow-Up","volume":"37","author":"Carryn","year":"2019","journal-title":"Vaccine"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2078","DOI":"10.1080\/21645515.2020.1871296","article-title":"Long-Term Immunogenicity after Measles Vaccine vs. Wild Infection: An Italian Retrospective Cohort Study","volume":"17","author":"Bianchi","year":"2021","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"eaao5945","DOI":"10.1126\/scitranslmed.aao5945","article-title":"Vaccine Waning and Mumps Re-Emergence in the United States","volume":"10","author":"Lewnard","year":"2018","journal-title":"Sci. Transl. Med."},{"key":"ref_30","unstructured":"Centers for Disease Control and Prevention, Hall, E., Wodi, A.P., Hamborsky, J., Morelli, V., and Schillie, S. (2021). Epidemiology and Prevention of Vaccine-Preventable Diseases."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1080\/14760584.2024.2331065","article-title":"The Durability of Vaccine-Induced Protection: An Overview","volume":"23","author":"Vashishtha","year":"2024","journal-title":"Expert Rev. Vaccines"},{"key":"ref_32","unstructured":"(2025, August 06). Ministro della Salute Le Novit\u00e0 Del Decreto-Legge Sui Vaccini: Decreto-Legge 7 Giugno 2017, Disposizioni Urgenti in Materia Di Prevenzione Vaccinale. Available online: https:\/\/www.normattiva.it\/uri-res\/N2Ls?urn:nir:stato:decreto.legge:2017-06-07;73!vig."},{"key":"ref_33","unstructured":"(2025, August 06). Istituto Superiore di Sanit\u00e0 Varicella Vaccination Coverage in Italy. Available online: https:\/\/www.epicentro.iss.it\/varicella\/aggiornamenti."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/infdis\/jiv748","article-title":"Antibody Levels and Protection after Hepatitis B Vaccine: Results of a 30-Year Follow-up Study and Response to a Booster Dose","volume":"214","author":"Bruce","year":"2016","journal-title":"J. Infect. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"5609","DOI":"10.1016\/j.vaccine.2018.07.043","article-title":"Immune Response to a Tdap Booster in Vertically HIV-Infected Adolescents","volume":"36","author":"Spina","year":"2018","journal-title":"Vaccine"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"263","DOI":"10.4161\/hv.36162","article-title":"Seroprevalence and Vaccination Coverage of Vaccine-Preventable Diseases in Perinatally HIV-1-Infected Patients","volume":"11","author":"Sticchi","year":"2015","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1086\/605448","article-title":"Immunogenicity and Immunologic Memory after Hepatitis B Virus Booster Vaccination in HIV-Infected Children Receiving Highly Active Antiretroviral Therapy","volume":"200","author":"Abzug","year":"2009","journal-title":"J. Infect. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1182\/blood-2005-11-013383","article-title":"Loss of Memory B Cells Impairs Maintenance of Long-Term Serologic Memory during HIV-1 Infection","volume":"108","author":"Titanji","year":"2006","journal-title":"Blood"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1867","DOI":"10.1097\/QAD.0b013e32833adbcf","article-title":"Long-Term Increase in CD4+ T-Cell Counts during Combination Antiretroviral Therapy for HIV-1 Infection","volume":"24","author":"Lok","year":"2010","journal-title":"AIDS"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e25804","DOI":"10.1002\/jia2.25804","article-title":"Innate and Adaptive Abnormalities in Youth with Vertically Acquired HIV through a Multicentre Cohort in Spain Integrated in the Translational Research Network in Pediatric Infectious Diseases (RITIP) 1","volume":"24","author":"Carrasco","year":"2021","journal-title":"J. Int. AIDS Soc."}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/13\/8\/871\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:29:06Z","timestamp":1760034546000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/13\/8\/871"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,16]]},"references-count":40,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["vaccines13080871"],"URL":"https:\/\/doi.org\/10.3390\/vaccines13080871","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,16]]}}}