title: Effectiveness of 23-valent polysaccharide pneumococcal vaccine on pneumonia in HIV-infected adults in the United States, 1998--2003.
abstract: 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.
authors.affiliation: 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
authors.forename: Eyasu H
authors.initials: EH
authors.lastname: Teshale
authors.forename: Debra
authors.initials: D
authors.lastname: Hanson
authors.forename: Brendan
authors.initials: B
authors.lastname: Flannery
authors.forename: Christina
authors.initials: C
authors.lastname: Phares
authors.forename: Mitchell
authors.initials: M
authors.lastname: Wolfe
authors.forename: Anne
authors.initials: A
authors.lastname: Schuchat
authors.forename: Patrick
authors.initials: P
authors.lastname: Sullivan
mesh_terms: 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
chemical_list: D022242:Pneumococcal Vaccines