title: Immunological efficacy of pneumococcal vaccine strategies in HIV-infected adults: a randomized clinical trial.
abstract: The aim of this study was to compare the immunologic response to a prime-boost immunization strategy combining the 13-valent conjugate pneumococcal vaccine (PCV13) with the 23-valent polysaccharide pneumococcal vaccine (PPSV23) versus the PPSV23 alone in HIV-infected adults. HIV-infected adults were randomized to receive PCV13 at week 0 followed by PPSV23 at week 4 (n = 31, prime-boost group) or PPSV23 alone at week 4 (n = 33, PPSV23-alone group). Serotype specific IgG geometric mean concentration (GMC) and functional oposonophagocytic (OPA) geometric mean titer (GMT) were compared for 12 pneumococcal serotypes shared by both vaccines at week 8 and week 28. The prime-boost vaccine group were more likely to achieve a ≥2-fold increase in IgG GMC and a GMC >1 ug/ml at week 8 (odds ratio (OR) 2.00, 95% confidence interval (CI) 1.46-2.74, p < 0.01) and week 28 (OR 1.95, 95% CI 1.40-2.70, p < 0.01). Similarly, the prime-boost vaccine group were more likely to achieve a ≥4-fold increase in GMT at week 8 (OR 1.71, 95% CI 1.22-2.39, p < 0.01) and week 28 (OR 1.6, 95% CI 1.15-2.3, p < 0.01). This study adds to evidence supporting current pneumococcal vaccination recommendations combining the conjugate and polysaccharide pneumococcal vaccines in the United States and Europe for HIV-infected individuals.
authors: Department of GU Medicine and Infectious Diseases (GUIDE), St James's Hospital, Dublin, Ireland.|School of Medicine, Trinity College Dublin, Dublin, Ireland.
authors: C
authors: C
authors: Sadlier
authors: Department of GU Medicine and Infectious Diseases (GUIDE), St James's Hospital, Dublin, Ireland.
authors: S
authors: S
authors: O'Dea
authors: Population Health Sciences Division, Royal College of Surgeons in Ireland, St Stephens Green, Dublin 2, Ireland.
authors: K
authors: K
authors: Bennett
authors: Department of Immunology, St James's Hospital, Dublin, Ireland.
authors: J
authors: J
authors: Dunne
authors: Department of Immunology, St James's Hospital, Dublin, Ireland.
authors: N
authors: N
authors: Conlon
authors: Department of GU Medicine and Infectious Diseases (GUIDE), St James's Hospital, Dublin, Ireland.|School of Medicine, Trinity College Dublin, Dublin, Ireland.
authors: C
authors: C
authors: Bergin
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000276:immunology*; D006801:Humans; D008297:Male; D022242:Pneumococcal Vaccines / Q000276:immunology* / Q000627:therapeutic use*; D011018:Pneumonia, Pneumococcal / Q000276:immunology / Q000517:prevention & control*
chemical_list: C538862:13-valent pneumococcal vaccine; C414006:23-valent pneumococcal capsular polysaccharide vaccine; D000907:Antibodies, Bacterial; D022242:Pneumococcal Vaccines