title: Safety and immunogenicity of 23-valent pneumococcal polysaccharide vaccine in HIV-1 infected former drug users.
abstract: The immunogenicity of 23-valent pneumococcal polysaccharide vaccine was assessed in 57 HIV-1 infected former intravenous drug users and in 20 HIV-1 negative controls. The effect of vaccination on HIV-1 infection was studied in a subgroup of 38 patients, 60% of whom under highly active antiretroviral therapy (HAART). Antibody to capsular polysaccharides from Streptococcus pneumoniae serotypes 3, 4, 6B, 19F, 23 F, and changes in CD4+ count, HIV-1 RNA, proviral DNA and HIV-1 phenotype were measured in pre- and post-vaccination samples. Vaccinations were well-tolerated. The rate of responders was higher (P<0.05) in HIV-1 negative than in HIV-1 infected individuals. No difference in antibody response was found within HIV-1 infected patients stratified according to CD4+ counts. Post-vaccination antibody geometric mean concentrations (GMCs) to the five antigens were higher (P<0.05) than baseline in HIV-1 negative subjects, but not in HIV-1 positive individuals. Those with CD4+ >500 cells/mm(3) showed a significant increase of antibody against type 3 only. Immunisation caused no significant changes in CD4+ counts and in either plasma HIV-1 RNA nor proviral DNA levels. Pneumococcal vaccination does not induce virological or immunological deterioration in HIV infected patients, but the antibody response to a single dose of vaccine is poor.
authors.affiliation: Institute of Virology, University of Milan, Via Pascal 38, 20133, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Amendola
authors.forename: E
authors.initials: E
authors.lastname: Tanzi
authors.forename: A
authors.initials: A
authors.lastname: Zappa
authors.forename: D
authors.initials: D
authors.lastname: Colzani
authors.forename: A
authors.initials: A
authors.lastname: Boschini
authors.forename: D M
authors.initials: DM
authors.lastname: Musher
authors.forename: A R
authors.initials: AR
authors.lastname: Zanetti
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology / Q000378:metabolism; D004279:DNA, Viral / Q000097:blood; D005260:Female; D015483:HIV Antibodies / Q000096:biosynthesis / Q000097:blood; D015658:HIV Infections / Q000188:drug therapy / Q000628:therapy*; D018023:HIV Seronegativity / Q000276:immunology; D006679:HIV Seropositivity / Q000276:immunology; D015497:HIV-1 / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D022242:Pneumococcal Vaccines / Q000009:adverse effects* / Q000276:immunology* / Q000627:therapeutic use; D011135:Polysaccharides, Bacterial / Q000009:adverse effects* / Q000276:immunology* / Q000627:therapeutic use; D011533:Proviruses / Q000235:genetics; D012367:RNA, Viral / Q000097:blood; D015819:Substance Abuse, Intravenous / Q000188:drug therapy / Q000628:therapy*; D016176:T-Lymphocyte Subsets / Q000276:immunology / Q000378:metabolism; D019562:Viral Load
chemical_list: C414006:23-valent pneumococcal capsular polysaccharide vaccine; D004279:DNA, Viral; D015483:HIV Antibodies; D022242:Pneumococcal Vaccines; D011135:Polysaccharides, Bacterial; D012367:RNA, Viral