title: Impact of human immunodeficiency virus infection on Streptococcus pneumoniae colonization and seroepidemiology among Zambian women.
abstract: Nasopharyngeal colonization with Streptococcus pneumoniae precedes invasive pneumococcal disease. Human immunodeficiency virus (HIV) infection increases rates of invasive pneumococcal disease, and its effect on colonization is unknown. In a longitudinal cohort of Zambian mothers with or without HIV infection, HIV infection increased the risk of colonization (risk ratio [RR], 1.9; 95% confidence interval [CI], 1.3-2.8) and repeat colonization (RR, 2.4; 95% CI, 1.1-5.3) and reduced the time to new colonization (P = .01). Repeat colonization with homologous sero/factor types occurred only among HIV-positive mothers. Pediatric serotypes 6, 19, and 23 accounted for excess colonization among HIV-positive mothers. HIV infection significantly increases the risk of pneumococcal colonization. Increased rates of colonization by pediatric serotypes suggest a potential role for the 7-valent pneumococcal vaccine in HIV-infected adults.
authors.affiliation: Center for International Health and Development, Boston University School of Public Health, Boston, Massachusetts 02118, USA. cgill@bu.edu
authors.forename: C J
authors.initials: CJ
authors.lastname: Gill
authors.forename: V
authors.initials: V
authors.lastname: Mwanakasale
authors.forename: M P
authors.initials: MP
authors.lastname: Fox
authors.forename: R
authors.initials: R
authors.lastname: Chilengi
authors.forename: M
authors.initials: M
authors.lastname: Tembo
authors.forename: M
authors.initials: M
authors.lastname: Nsofwa
authors.forename: V
authors.initials: V
authors.lastname: Chalwe
authors.forename: L
authors.initials: L
authors.lastname: Mwananyanda
authors.forename: D
authors.initials: D
authors.lastname: Mukwamataba
authors.forename: B
authors.initials: B
authors.lastname: Malilwe
authors.forename: D
authors.initials: D
authors.lastname: Champo
authors.forename: W B
authors.initials: WB
authors.lastname: Macleod
authors.forename: D M
authors.initials: DM
authors.lastname: Thea
authors.forename: D H
authors.initials: DH
authors.lastname: Hamer
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008137:Longitudinal Studies; D009035:Mothers; D010614:Pharynx / Q000382:microbiology; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D016036:Seroepidemiologic Studies; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000276:immunology / Q000302:isolation & purification*; D015024:Zambia / Q000453:epidemiology