title: Quantitative and Functional Antibody Responses to the 13-Valent Conjugate and/or 23-Valent Purified Polysaccharide Vaccine in Aging HIV-Infected Adults.
abstract: BACKGROUND
  The number of aging human immunodeficiency virus-infected (HIV+) individuals living in the United States has substantially grown over the past two decades. Advanced age and HIV infection both increase susceptibility toStreptococcus pneumoniaeinfection due to B cell dysfunction. The combined impact of these factors on pneumococcal vaccine responses remains unknown.
  
  
  METHODS
  We assessed serum immunoglobulin (Ig) G and IgM levels and opsonophagocytic killing assay (OPA) titers to pneumococcal serotypes 14 and 23F in HIV+ subjects and HIV-uninfected (HIV-) controls 50-65 years old. HIV+ individuals with CD4+T cells/μl (CD4) >200 and ≥1 year of antiretroviral therapy (ART) received either a dose of the 13-valent pneumococcal conjugate vaccine followed by the 23-valent pneumococcal polysaccharide vaccine 8 weeks later (PCV/PPV) as currently recommended (n=15) or a single dose of PPV only (n=22). HIV- controls received PCV/PPV (n=14).
  
  
  RESULTS
  HIV+ PCV/PPV and PPV groups exhibited similar increases in IgG levels and OPA titers for both serotypes after immunization. Postvaccination IgM levels for serotype 23F, but not 14, were significantly higher in HIV+ PCV/PPV compared to PPV groups. IgG and IgM levels for serotype 14 and OPA titers to serotype 23F were significantly reduced in HIV+ compared to HIV- PCV/PPV groups. Serotype-specific IgG levels correlated with OPA titers for all groups.
  
  
  CONCLUSIONS
  Our data suggest that the recommended PCV/PPV regimen may not significantly improve quantitative or functional antibody responses compared to PPV only in aging HIV+ subjects. Continued efforts aimed at improving vaccine responses in this high risk population are warranted.
authors.affiliation: Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Ohtola
authors.affiliation: Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Saul-McBeth
authors.affiliation: Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio.
authors.forename: Anita S
authors.initials: AS
authors.lastname: Iyer
authors.affiliation: Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio.
authors.forename: David J
authors.initials: DJ
authors.lastname: Leggat
authors.affiliation: Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio; Department of Public Health and Preventative Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio.
authors.forename: Sadik A
authors.initials: SA
authors.lastname: Khuder
authors.affiliation: Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio.
authors.forename: Noor M
authors.initials: NM
authors.lastname: Khaskhely
authors.affiliation: Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio; Department of Pathology, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio; Department of Medical Microbiology and Immunology, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio.
authors.forename: Ma Julie
authors.initials: MJ
authors.lastname: Westerink
keywords: Aging; Antibody; HIV infection; Human; Pneumococcal conjugate vaccine; Pneumococcal polysaccharide vaccine; Streptococcus pneumoniae