title: Reimmunization with 23-valent pneumococcal vaccine for patients infected with human immunodeficiency virus type 1: clinical, immunologic, and virologic responses.
abstract: We determined the immunogenicity and safety of reimmunization with the 23-valent polysaccharide pneumococcal vaccine in patients infected with human immunodeficiency virus type 1 (HIV-1). Patients immunized >5 years earlier (initially within 1 year of HIV-1 seroconversion) were randomized to receive vaccine (n=57) or placebo (n=30). Persons with recent HIV-1 seroconversion (n=14) were immunized for the first time. Preimmunization levels of capsule-specific immunoglobulin G were similar in all groups. Reimmunized patients showed a significantly lower frequency and magnitude of antibody responses compared with persons with recent HIV-1 seroconversion. Reimmunized patients did not show adverse virologic or immunologic changes, but some reported local discomfort (15%) or fever (8%). Thus, the limited responses after reimmunization of HIV-1-infected patients with the current 23-valent vaccine mandates the need for a more effective reimmunization schedule, more immunogenic vaccines, or other behavioral and therapeutic interventions.
authors.affiliation: US Naval Medical Center, San Diego, CA, USA.
authors.forename: Sybil A
authors.initials: SA
authors.lastname: Tasker
authors.forename: Mark R
authors.initials: MR
authors.lastname: Wallace
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Rubins
authors.forename: William B
authors.initials: WB
authors.lastname: Paxton
authors.forename: James
authors.initials: J
authors.lastname: O'Brien
authors.forename: Edward N
authors.initials: EN
authors.lastname: Janoff
mesh_terms: D000328:Adult; D000917:Antibody Formation / Q000187:drug effects*; D018791:CD4 Lymphocyte Count; D004311:Double-Blind Method; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000276:immunology* / Q000821:virology; D006679:HIV Seropositivity; D015497:HIV-1 / Q000235:genetics / Q000276:immunology*; D006801:Humans; D007114:Immunization; D008297:Male; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D012367:RNA, Viral / Q000097:blood
chemical_list: D022242:Pneumococcal Vaccines; D012367:RNA, Viral