Effectiveness of 23-valent polysaccharide pneumococcal vaccine on pneumonia in HIV-infected adults in the United States, 1998--2003.
Pneumococcal polysaccharide vaccine (PPV-23) has been recommended for HIV-infected adults. We investigated factors that could influence PPV-23 effectiveness against all-cause pneumonia in a longitudinal cohort of 23,255 HIV-infected adults receiving care during 1998--2003. Patients who received PPV-23 had a lower rate of pneumonia (IRR = 0.8; 95% CI: 0.8-0.9) than patients who had never been vaccinated, independent of recent CD4 count, HIV viral load, antiretroviral therapy, and history of pneumonia. However, PPV-23 provided no benefit when patients were vaccinated at HIV viral load > 100,000 copies/ml, irrespective of CD4 count at vaccination. Receipt of PPV-23 was associated with lower incidence of all-cause pneumonia.
Teshale
Eyasu H
EH
Centers for Disease Control and Prevention, National Center for HIV, Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, USA. eht4@cdc.gov
Hanson
Debra
D
Flannery
Brendan
B
Phares
Christina
C
Wolfe
Mitchell
M
Schuchat
Anne
A
Sullivan
Patrick
P
D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D023381:Endpoint Determination; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications* / Q000276:immunology* / Q000821:virology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D022242:Pneumococcal Vaccines / Q000276:immunology* / Q000627:therapeutic use*; D011018:Pneumonia, Pneumococcal / Q000150:complications / Q000276:immunology* / Q000517:prevention & control*; D012959:Socioeconomic Factors; D014481:United States; D019562:Viral Load; D055815:Young Adult
D022242:Pneumococcal Vaccines