title: Longitudinal study on Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus nasopharyngeal colonization in HIV-infected and -uninfected infants vaccinated with pneumococcal conjugate vaccine.
abstract: BACKGROUND
  Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus are all potentially pathogenic, which frequently colonize the nasopharynx (NP) prior to causing disease. We studied bacterial NP-colonization in 321 HIV-infected and 243 HIV-uninfected children vaccinated with 7-valent pneumococcal conjugate vaccine (PCV7) at 6, 10 and 14 weeks of age.
  
  
  METHODS
  HIV-uninfected infants included those born to HIV-uninfected (HUU) and HIV-infected women (HEU); HIV-infected children with CD4+ lymphocyte ≥25% were randomized to initiate antiretroviral therapy immediately (ART-Immed) or when clinically indicated (ART-Def). Nasopharyngeal swabs for bacterial culture were taken prior to each PCV7 dose (Visits 1-3) and at 20, 39, 47 and 67 weeks of age (Visits 4-7). Swabs were cultured by standard methods and pneumococcal serotyping done by the Quellung method.
  
  
  RESULTS
  Colonization patterns for pneumococcus, H. influenzae and S. aureus did not differ between HUU and HEU children; and were also generally similar between ART-Def and ART-Immed children. Prevalence of PCV7-serotype colonization was similar between HIV-infected and HIV-uninfected children, however, overall pneumococcal and specifically non-vaccine serotype colonization tended to be lower in HIV-infected children. HIV-infected children also had a 44% lower prevalence of S. aureus colonization at Visit-1 (p=0.010); and H. influenzae colonization was also lower among HIV-infected than HIV-uninfected children at Visit-2, Visit-3, Visit-6 and Visit-7.
  
  
  CONCLUSIONS
  Vaccine-serotype colonization is similar in PCV-immunized HIV-infected and HIV-uninfected children. We, however, identified a lower prevalence of overall-pneumococcal and H. influenzae colonization in HIV-infected children post-PCV vaccination, the clinical-relevance of which warrants further study.
authors.affiliation: National Institute for Communicable Diseases - A Division of National Health Laboratory Service, Sandringham, South Africa; Department of Science/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa. Electronic address: madhis@rmpru.co.za.
authors.forename: Shabir A
authors.initials: SA
authors.lastname: Madhi
authors.affiliation: Department of Science/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa.
authors.forename: Alane
authors.initials: A
authors.lastname: Izu
authors.affiliation: Department of Science/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa.
authors.forename: Marta C
authors.initials: MC
authors.lastname: Nunes
authors.affiliation: University of Witwatersrand, Perinatal HIV Research Unit, Johannesburg, South Africa.
authors.forename: Avye
authors.initials: A
authors.lastname: Violari
authors.affiliation: Children's Infectious Diseases Clinical Research Unit, Department of Paediatrics & Child Health, Faculty Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
authors.forename: Mark F
authors.initials: MF
authors.lastname: Cotton
authors.affiliation: Henry Jackson Foundation, Division of AIDS (HJF-DAIDS), A Division of The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Contractor to NIAID, NIH, DHHS, Bethesda, MD, United States.
authors.forename: Patrick
authors.initials: P
authors.lastname: Jean-Philippe
authors.affiliation: Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa.
authors.forename: Keith P
authors.initials: KP
authors.lastname: Klugman
authors.affiliation: National Institute for Communicable Diseases - A Division of National Health Laboratory Service, Sandringham, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa.
authors.forename: Anne
authors.initials: A
authors.lastname: von Gottberg
authors.affiliation: Department of Science/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa.
authors.forename: Nadia
authors.initials: N
authors.lastname: van Niekerk
authors.affiliation: Department of Science/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa.
authors.forename: Peter V
authors.initials: PV
authors.lastname: Adrian
mesh_terms: D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006192:Haemophilus Infections / Q000453:epidemiology* / Q000382:microbiology; D006193:Haemophilus influenzae / Q000302:isolation & purification; D000069443:Heptavalent Pneumococcal Conjugate Vaccine / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D009305:Nasopharynx / Q000382:microbiology*; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D015995:Prevalence; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013296:Streptococcus pneumoniae / Q000302:isolation & purification
chemical_list: D000069443:Heptavalent Pneumococcal Conjugate Vaccine
keywords: Colonization; HIV; HIV exposure; Haemophilus influenzae; Pneumococcal conjugate vaccine; Staphylococcus aureus; Streptococcus pneumoniae