title: Invasive pneumococcal disease (IPD) in HIV infected patients in Israel since the introduction of pneumococcal conjugated vaccines (PCV): Analysis of a nationwide surveillance study, 2009-2014.
abstract: to assess the incidence, risk factors and outcome of invasive pneumococcal disease (IPD) among the Israeli HIV population. A matched case-control study nested in a nationwide, prospective, population-based, cohort of adult IPD was performed. In addition, the HIV-IPD patients were compared to the general adult HIV population in Israel.
  
  
  
  from the introduction of PCV into the national immunization program (NIP) in July 2009 to June 2014. Each HIV patient within the IPD cohort was matched to 4 non-HIV controls. Serotyping was performed by a central laboratory using the Quellung reaction. Thirty-five IPD episodes in 33 HIV patients were identified, with a median annual incidence of 128/100,000 HIV+ persons compared to 5.1/100,000 in the age-matched, non-HIV population. Compared to the general HIV population, HIV-IPD patients practiced intravenous drug use more frequently and originated from a country with generalized epidemic (OGE), mainly non-citizens lacking medical insurance. The proportion of men who have sex with men (MSM) was lower than in the general HIV population. Pneumonia was the most common clinical presentation (81%), while meningitis occurred in only one patient. Outcomes were similar to those of the IPD non-HIV population. Nineteen serotypes were identified, of which only 42% were covered by PCV13 vaccine. By 2014, none of the HIV-IPD cases belonged to serotypes covered by PCV13. In conclusion, most HIV IPD cases were from marginalized populations with poor access to health services. A decrease in IPD cases covered by PCV 13 was observed.
authors.affiliation: a Infectious Diseases Unit, Meir Medical Center, Kfar Saba, and the Sackler Faculty of Medicine, Tel Aviv University , Ramat Aviv , Israel.
authors.forename: Michal
authors.initials: M
authors.lastname: Chowers
authors.affiliation: b Infectious Diseases Unit, Sheba Medical Center, Ramat Gan, and the Sackler Faculty of Medicine, Tel Aviv University , Ramat Aviv , Israel.
authors.forename: Gili
authors.initials: G
authors.lastname: Regev-Yochay
authors.affiliation: c Central Virology Laboratory, The Israeli Ministry of Health, Sheba Medical Center , Ramat Gan , Israel.
authors.forename: Orna
authors.initials: O
authors.lastname: Mor
authors.affiliation: d Infectious Diseases Unit, Tel Aviv Medical Center , Tel Aviv , Israel.
authors.forename: Ronit
authors.initials: R
authors.lastname: Cohen-Poradosu
authors.affiliation: e Infectious Diseases Unit, Soroka Medical Center, and the Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer Sheva , Israel.
authors.forename: Klaris
authors.initials: K
authors.lastname: Riesenberg
authors.affiliation: f Infectious Diseases Unit, Kaplan Medical Center , Rehovot , Israel.
authors.forename: Oren
authors.initials: O
authors.lastname: Zimhony
authors.affiliation: g Department of Tuberculosis & AIDS , the Israeli Ministry of Health , Jerusalem , Israel.
authors.forename: Daniel
authors.initials: D
authors.lastname: Chemtob
authors.affiliation: h Infectious Diseases Unit, Hillel Yaffe Medical Center , Hadera , Israel.
authors.forename: Michal
authors.initials: M
authors.lastname: Stein
authors.affiliation: i the Faculty of Health Sciences, Ben Gurion University of the Negev , Beer Sheva , Israel.
authors.forename: Ron
authors.initials: R
authors.lastname: Dagan
authors.affiliation: j Infectious Diseases Unit Sheba Medical Center, Ramat Gan, and the Sackler Faculty of Medicine, Tel Aviv University , Ramat Aviv , Israel.
authors.forename: Itzchak
authors.initials: I
authors.lastname: Levy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology* / Q000517:prevention & control; D016022:Case-Control Studies; D062665:Epidemiological Monitoring; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008297:Male; D008586:Meningitis, Pneumococcal / Q000453:epidemiology* / Q000517:prevention & control; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D011446:Prospective Studies; D012307:Risk Factors; D065288:Serogroup; D013296:Streptococcus pneumoniae / Q000145:classification / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D022242:Pneumococcal Vaccines
keywords: HIV; incidence; invasive pneumococcal disease; vaccine