HIV and pneumococcal disease.
OBJECTIVE
To describe the impact of highly active antiretroviral therapy on the burden of pneumococcal disease and advances in our understanding of the impact of HIV on this disease.


RESULTS
Although highly active antiretroviral therapy has reduced the burden of pneumococcal disease among HIV-infected adults, these infections remain far more common than in HIV uninfected adults. HIV-infected adults who smoke or have comorbidities are at particular risk. In the absence of highly active antiretroviral therapy, pneumococcal meningitis has emerged in Africa as a major disease burden with a high mortality among HIV-infected children and adults. Conjugate pneumococcal vaccine protects HIV-infected infants from pneumococcal pneumonia. In the United States, where conjugate vaccine is given to children, herd immunity has reduced the burden of invasive pneumococcal disease among HIV-infected adults.


CONCLUSIONS
The pneumococcus remains a significant cause of morbidity and mortality among HIV-infected children and adults, both in developed and in developing countries.
Klugman
Keith P
KP
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA. keith.klugman@emory.edu
Madhi
Shabir A
SA
Feldman
Charles
C
D044966:Anti-Retroviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D017281:Cost of Illness; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000209:etiology; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D018074:Vaccines, Conjugate / Q000627:therapeutic use
D044966:Anti-Retroviral Agents; D018074:Vaccines, Conjugate