AUTHOR=Habibzadeh Farrokh , Yadollahie Mahboobeh , Simi Ashraf 

TITLE=Use of Oral Polio Vaccine and the Global Incidence of Mother-to-Child Human Immunodeficiency Virus Transmission

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.878298

DOI=10.3389/fpubh.2022.878298

ISSN=2296-2565

ABSTRACT=Background: Mother-to-child transmission (MTCT) of HIV is an important global health issue. We hypothesized that live attenuated poliovirus existing in oral polio vaccine (OPV) may protect uninfected neonates born to HIV-positive mothers through the stimulation of innate immune system.
Objective: To test the hypothesis that countries using OPV have a lower MTCT rate (due to postnatal protection provided by the vaccine) compared with those using only inactivated polio vaccine (IPV).
Methods: In an ecological study, the incidence of HIV/AIDS in children aged <1 year (IncHIV1), considered a surrogate index for MTCT rate, was compared between countries using OPV vs IPV. The aggregated population data were retrieved for 204 countries from the Global Burden of Disease Collaborative Network website, “Our World in Data” website, the World Bank website, and the WHO Global Polio Eradication Initiative (GPEI). We used a negative binomial regression model with IncHIV1 as the dependent variable and the prevalence of HIV/AIDS in women aged 15–49 years (PrevHIV), antiretroviral therapy (ART) coverage, human development index (HDI), and the type of vaccine used in each country as independent variables. Multivariate imputation by chained equations was used to treat missing values. Analyses were performed for both the original dataset (with missing values) and the 5 imputed datasets.
Results: IncHIV1 and PrevHIV were available for all 204 countries; vaccine type, 194 countries; HDI, 182 countries; and ART coverage, 133 countries. 129 countries in the original dataset had complete data for all the above-mentioned variables; The imputed datasets had complete data for all countries. The results obtained from the analysis of the original dataset had no overall difference with the pooled results obtained from the analysis of 5 imputed datasets. Countries with higher HDI mainly use IPV; those with lower HDI commonly use OPV. PrevHIV, HDI, and the type of vaccine were independent predictors of IncHIV1. Use of OPV compared to IPV, was independently associated with an average decrease of 17% in IncHIV1 at median HDI of 0.75. The protection provided by OPV increased in countries with lower HDI.
Conclusions: Use of OPV compared with IPV, was independently associated with lower MTCT rate.