title: Streptococcus pneumoniae colonization, bacteremia, and immune response among persons with human immunodeficiency virus infection.
abstract: Although invasive pneumococcal infections are common among men infected with human immunodeficiency virus (HIV), the prevalence of pharyngeal colonization with Streptococcus pneumoniae was not significantly different among HIV-infected patients (8 [14%] of 56) and HIV-seronegative men (9 [9%] of 99) attending a sexually transmitted disease clinic. Sixteen HIV-infected men (mean CD4+ T cell count, 132 +/- 37/microL) developed pneumococcal bacteremia, accounting for 13.6% of 117 total cases and 42% of 38 cases in men 16-55 years old. Serum killing activity, a measure of functional humoral response to S. pneumoniae, was lower in 4 (67%) of 6 acute sera and 6 (54%) of 11 convalescent sera from bacteremic HIV-infected patients when compared with baseline sera of 7 HIV-seronegative healthy subjects. These findings suggest that the high rates of pneumococcal bacteremia among HIV-infected patients may be associated with low numbers of CD4+ T cells and impaired humoral responses to S. pneumoniae rather than to increased exposure to the organism.
authors.affiliation: Department of Medicine, VA Medical Center, Minneapolis, MN 55417.
authors.forename: E N
authors.initials: EN
authors.lastname: Janoff
authors.forename: J
authors.initials: J
authors.lastname: O'Brien
authors.forename: P
authors.initials: P
authors.lastname: Thompson
authors.forename: J
authors.initials: J
authors.lastname: Ehret
authors.forename: G
authors.initials: G
authors.lastname: Meiklejohn
authors.forename: G
authors.initials: G
authors.lastname: Duvall
authors.forename: J M
authors.initials: JM
authors.lastname: Douglas
mesh_terms: D000293:Adolescent; D000328:Adult; D001770:Blood Bactericidal Activity; D015496:CD4-Positive T-Lymphocytes; D015658:HIV Infections / Q000150:complications* / Q000276:immunology / Q000382:microbiology; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000382:microbiology*; D011008:Pneumococcal Infections / Q000150:complications* / Q000276:immunology / Q000382:microbiology; D012307:Risk Factors; D018805:Sepsis / Q000150:complications* / Q000276:immunology / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*