title: Rapid loss of specific antibodies after pneumococcal vaccination in patients with human immunodeficiency virus-1 infection.
abstract: Pneumococcal infections are frequently observed in patients with human immunodeficiency virus (HIV) infection and active immunization has been recommended as prophylaxis in this patient group. We studied 103 out-patients with asymptomatic or mildly symptomatic HIV infection with respect to specific IgG and IgG2 pneumococcal antibodies before and after vaccination with a 23-valent pneumococcal polysaccharide vaccine. A significant increase ( > 2-fold) in IgG and IgG2 antibody levels was observed after 1 month in 69/103 patients (67%) with no correlation with the CD4 cell count at the time of vaccination. The response rate was not influenced by concurrent treatment with anti-retroviral monotherapy, or by age or gender. After immunization a strong correlation between IgG and IgG2 anti-pneumococcal antibodies was demonstrated. Nevertheless, 12 months after vaccination the specific antibody titres were not significantly different from pre-vaccination values. In conclusion, antibodies induced by pneumococcal vaccination in patients with HIV infection have a short duration. This raises the question as to whether vaccination will have any impact on clinical end-point in this group of patients.
authors.affiliation: Department of Infectious Diseases, Rigshospitalet, Hvidovre, Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Nielsen
authors.forename: B
authors.initials: B
authors.lastname: Kvinesdal
authors.forename: T L
authors.initials: TL
authors.lastname: Benfield
authors.forename: J D
authors.initials: JD
authors.lastname: Lundgren
authors.forename: H B
authors.initials: HB
authors.lastname: Konradsen
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology*; D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D001428:Bacterial Vaccines / Q000276:immunology*; D018791:CD4 Lymphocyte Count; D005260:Female; D015497:HIV-1; D006801:Humans; D007074:Immunoglobulin G / Q000145:classification; D008297:Male; D008875:Middle Aged; D022242:Pneumococcal Vaccines; D013296:Streptococcus pneumoniae / Q000276:immunology*; D014611:Vaccination
chemical_list: D000907:Antibodies, Bacterial; D001428:Bacterial Vaccines; D007074:Immunoglobulin G; D022242:Pneumococcal Vaccines