title: Association of time since pneumococcal polysaccharide vaccine receipt and CD4 count with antibody response to the 13-valent pneumococcal conjugate vaccine in HIV-infected adults.
abstract: Pneumococcal infection is a leading cause of illness and death in HIV-infected adults. Current United States guidelines for HIV-infected adults recommend a single dose of the 13-valent pneumococcal conjugate vaccine (PCV-13) at any CD4 count and at least 1 y after receipt of the 23-valent pneumococcal polysaccharide vaccine (PPV). PPV is known to lead to hyporesponsiveness to subsequent pneumococcal vaccines for at least 1 y Whether PCV-13 would be more immunogenic if administered later after PPV receipt or at higher CD4 counts has not been tested.
  
  
  
  We prospectively collected serum from 96 HIV-infected adults before and after PCV-13 receipt, and measured antibody concentrations against 4 pneumococcal serotypes (3, 6A, 7F, and 19A) via indirect ELISA according to the WHO protocol. Post-booster antibody concentrations and fold-rise in antibody concentrations were compared according to time from PPV receipt and baseline CD4 count using univariate and multivariate analyses.
  
  
  
  PPV receipt >3 versus 1-3 y prior did not significantly change post-vaccination antibody concentrations, but was associated with slightly higher fold-rise in antibody concentration for the 3 tested serotypes included in PPV, though this only reached significance for serotype 7F. CD4 count was significantly associated with post-vaccination antibody concentrations for 3 of 4 serotypes, but not for fold-rise in antibody concentration for any serotype.
  
  
  
  Waiting longer than 1 y after PPV receipt to administer PCV-13 may slightly improve the antibody response to serotypes included in both vaccines. While higher CD4 count at PCV-13 administration results in higher post-vaccination antibody concentrations, this is likely because higher CD4 count is also associated with higher pre-vaccination antibody concentrations.
authors.affiliation: a Department of Internal Medicine , Eastern Virginia Medical School , Norfolk , VA , USA.
authors.forename: Alexandria E-B
authors.initials: AE
authors.lastname: Rossheim
authors.affiliation: a Department of Internal Medicine , Eastern Virginia Medical School , Norfolk , VA , USA.
authors.forename: Anna Marie P
authors.initials: AM
authors.lastname: Young
authors.affiliation: a Department of Internal Medicine , Eastern Virginia Medical School , Norfolk , VA , USA.
authors.forename: Julia
authors.initials: J
authors.lastname: Siik
authors.affiliation: b Center for Health Analytics and Discovery, Eastern Virginia Medical School , Norfolk , VA , USA.
authors.forename: Tina D
authors.initials: TD
authors.lastname: Cunningham
authors.affiliation: a Department of Internal Medicine , Eastern Virginia Medical School , Norfolk , VA , USA.
authors.forename: Stephanie B
authors.initials: SB
authors.lastname: Troy
mesh_terms: D000328:Adult; D000368:Aged; D000917:Antibody Formation; D018791:CD4 Lymphocyte Count; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D011446:Prospective Studies; D013997:Time Factors; D014481:United States; D055815:Young Adult
chemical_list: C538862:13-valent pneumococcal vaccine; D022242:Pneumococcal Vaccines
keywords: CD4 Count; HIV; Pneumovax; Prevnar; adults; pneumococcus; vaccine