The Immunogenicity and Safety of the Live-Attenuated CYD-Tetravalent Dengue Vaccine( CYD-TDV) in Children and Adolescents: A Systematic Review of Randomized Controlled Trials
Raksheeth Agarwal a, Oliver Emmanuel b, Sharon Hanmy Angel c, Angga Wiratama d
a) Universitas Indonesia –(+ 62) 85777808310, raksheeth @ hotmail. com
b) Universitas Indonesia –(+ 62) 818635925, oliveremmanuel @ hotmail. com
c) Universitas Indonesia –(+ 62) 81362873803, sharonhanmyangel @ gmail. com d)
Introduction:
The incidence of dengue disease is increasing dramatically across the world, with about 3.9 billion people from 128 countries at risk of infection. Indonesia, an endemic region, experienced dengue outbreaks in 12 regencies that resulted in 608 cases and 34 deaths in early 2016. Moreover, studies show that the constantly increasing global temperatures enhances the growth and spread of both virus and its vector. This calls for a more effective prevention strategy for dengue disease. Vaccination, when integrated into current vector control methods, has the potential to significantly improve dengue prevention. A tetravalent dengue vaccine, CYD-TDV( Dengvaxia), has the antigens of all 4 serotypes of dengue virus. The purpose of this review is to assess the immunogenicity and safety of CYD-TDV in children.
Methods:
Comprehensive literature searches were conducted on databases Pubmed, The Cochrane Library, Scopus, ProQuest, EBSCOhost and ScienceDirect. Randomizedcontrolled trials on children with CYD-TDV as intervention were selected. Trials were further filtered using inclusion and exclusion criteria. Data extracted from selected trials include safety of vaccine and immunogenicity in terms of Geometric Mean Titres( GMT) of antibodies.
Results:
Six clinical trials were selected based on preset criteria. GMT values were obtained using 50 % Plaque Reduction Neutralization Test( PRNT) and safety was semiquantitatively assesed based on adverse effects. Additional processing of data was done to better understand the trends among trials, including fold increase of GMT from baseline to post dose 3 and peak GMT values achieved.