Journal Article

Response of Human Immunodeficiency Virus–Infected Patients Receiving Highly Active Antiretroviral Therapy to Vaccination with 23-Valent Pneumococcal Polysaccharide Vaccine

Maria C. Rodriguez-Barradas, Irene Alexandraki, Tabinda Nazir, Michael Foltzer, Daniel M. Musher, Sheldon Brown and John Thornby

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 37, issue 3, pages 438-447
Published in print August 2003 | ISSN: 1058-4838
Published online August 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/375841
Response of Human Immunodeficiency Virus–Infected Patients Receiving Highly Active Antiretroviral Therapy to Vaccination with 23-Valent Pneumococcal Polysaccharide Vaccine

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Whether highly active antiretroviral therapy (HAART) impacts responses to 23-valent pneumococcal polysaccharide vaccine (PV) is not known. Immunoglobulin G (IgG) levels for 6 capsular polysaccharides in human immunodeficiency virus (HIV)–infected patients who had received ⩾6 months of HAART were measured either after their first dose of PV (n = 46) or after revaccination (n = 41); control subjects had never received HAART and had received the first dose of PV (n = 38). There were no significant differences in pre- or postvaccination IgG levels among these groups but for 1 capsular polysaccharide. The 3 groups had significant postvaccination increases in IgG levels to all capsular polysaccharides. The control group had a greater number of 2-fold responses than did the combined HAART groups (P < .05). Patients with a CD4 cell count of ⩾200 cells/mm3 had a greater number of 2-fold responses than did those with a CD4 cell count of <200 cells/mm3 (P < .05). For revaccinated patients, postvaccination IgG levels were correlated with the CD4 cell count at the initial vaccination. The immunogenicity of PV among patients receiving long-term HAART is modest. It seems best to immunize HIV-infected patients early in the course of disease.

Journal Article.  5093 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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