title: Response of human immunodeficiency virus-infected patients receiving highly active antiretroviral therapy to vaccination with 23-valent pneumococcal polysaccharide vaccine.
abstract: Whether highly active antiretroviral therapy (HAART) impacts responses to 23-valent pneumococcal polysaccharide vaccine (PV) is not known. Immunoglobulin G (IgG) levels for 6 capsular polysaccharides in human immunodeficiency virus (HIV)-infected patients who had received > or =6 months of HAART were measured either after their first dose of PV (n=46) or after revaccination (n=41); control subjects had never received HAART and had received the first dose of PV (n=38). There were no significant differences in pre- or postvaccination IgG levels among these groups but for 1 capsular polysaccharide. The 3 groups had significant postvaccination increases in IgG levels to all capsular polysaccharides. The control group had a greater number of 2-fold responses than did the combined HAART groups (P<.05). Patients with a CD4 cell count of > or =200 cells/mm3 had a greater number of 2-fold responses than did those with a CD4 cell count of <200 cells/mm3 (P<.05). For revaccinated patients, postvaccination IgG levels were correlated with the CD4 cell count at the initial vaccination. The immunogenicity of PV among patients receiving long-term HAART is modest. It seems best to immunize HIV-infected patients early in the course of disease.
authors.affiliation: Baylor College of Medicine, Houston, Texas, USA. maria.rodriguez-barradas2@med.va.gov
authors.forename: Maria C
authors.initials: MC
authors.lastname: Rodriguez-Barradas
authors.forename: Irene
authors.initials: I
authors.lastname: Alexandraki
authors.forename: Tabinda
authors.initials: T
authors.lastname: Nazir
authors.forename: Michael
authors.initials: M
authors.lastname: Foltzer
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Musher
authors.forename: Sheldon
authors.initials: S
authors.lastname: Brown
authors.forename: John
authors.initials: J
authors.lastname: Thornby
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005260:Female; D006678:HIV / Q000187:drug effects; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000276:immunology*; D013223:Statistics as Topic; D014611:Vaccination
chemical_list: D007074:Immunoglobulin G; D022242:Pneumococcal Vaccines