A case-control study to investigate serological correlates of clinical failure of 23-valent pneumococcal polysaccharide vaccine in HIV-1-infected Ugandan adults.
We have investigated the association between the concentration of anti-polysaccharide pneumococcal capsule-specific (anti-PS) immunoglobulin G and the killing activity, in serum, in invasive pneumococcal disease (IPD) events and response to 23-valent polysaccharide vaccine in human immunodeficiency virus (HIV)-infected Ugandans. Case patients with IPD had lower concentrations of anti-PS IgG before and after vaccination and before the IPD event (P<.01 for 5 [i.e., 4, 9V, 14, 18C, and 19F] of 6 serotypes assessed). After vaccination, case patients were less likely than were control subjects to develop detectable serum killing activity against the 2 serotypes tested--for 19F, this activity was detected in 16% of case patients versus 37% of control subjects (P=.08); for 23F, it was detected in 11% of case patients versus 40% of control subjects (P=.02). Thus, absolute concentration of anti-PS IgG and an attenuated response to polysaccharide are associated with risk of IPD in HIV-infected adults.
Liverpool School of Tropical Medicine, Liverpool, United Kingdom. nfrench@mlw.medcol.mw
Neil
N
French
Michael
M
Moore
Raili
R
Haikala
Helena
H
Kayhty
Charles F
CF
Gilks
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D016022:Case-Control Studies; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000276:immunology*; D015497:HIV-1; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D009895:Opsonin Proteins / Q000097:blood; D011008:Pneumococcal Infections / Q000097:blood / Q000150:complications / Q000276:immunology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000276:immunology*; D011134:Polysaccharides / Q000276:immunology; D013296:Streptococcus pneumoniae / Q000737:chemistry / Q000276:immunology*; D016896:Treatment Outcome; D014454:Uganda; D014611:Vaccination
D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D009895:Opsonin Proteins; D022242:Pneumococcal Vaccines; D011134:Polysaccharides