http://www.100md.com
Elisa García Vázquez1,Jordi Yagüe1,Felip
HIV;,pneumococcal,vaccination;,polysaccharide,vaccine;,conjugate,vaccine,AntibodyresponsetoS.pneumoniaeaftervaccinationwiththe23-valentpneumococcalpo
Antibody response to S.pneumoniae after vaccination with the 23-valent pneumococcal polysaccharide vaccine versus 7-valent conjugate vaccine in HIV patients with nadir CD4 count≥200 cells/μl(pdf)
Hospital Clinic. Barcelona. Spain
Correspondence to Dr. Elisa García Vázquez,Servicio de Medicina Interna-Infecciones,Hospital Universitario Virgen de la Arrixaca,Ctra. Madrid-Cartagena
30120 El Palmar (Murcia)
Tel:00 34 968 36 95 00,Fax:00 34 968 36 96 78
E-mail:elisag@eresmas.net
[Abstract] Objective To assess antibody response to capsular polysaccharides after vaccination with 23-valent pneumococcal polysaccharide vaccine (PPV) compared to that of 7-valent conjugate vaccine (CV).Methods 149 HIV positive patients (nadir CD4 count≥200 cells/μl) were randomised into: a) PPV (n=75); or b) CV (n=74). Blood samples were obtained prior to and 4 weeks after vaccination and levels of pneumococcal capsule-specific IgG antibody were measured by an ELISA test. “Seroconversion” was defined as an increase in antibody titers >395 U/ml. End point was rate of seroconversion in each group. Results 65/149 patients (43.6%) were seroconverters. There was a trend to higher rate of seroconversion in PPV group (50.7%) than in CV group (36.5%) (P=0.08). In multivariate analysis, factors associated with increased rate of immunogenic response to vaccination included having received PPV (OR 2.75; 95% CI 1.27~5.93) and undetectable prevacunal viral load (VL) (OR 3.30; 95% CI 1.39~7.84). After vaccination, an increase in mean VL (2.42 log. vs 2.69;P=0.004) and in mean CD4 count (627 cells/μl vs. 679;P=0.03) were observed.Conclusions Rate of seroconversion to pneumococcal vaccine is higher in PPV group than in CV group in HIV positive patients with nadir CD4 count≥200 cells/μl (OR 2.75). Immunization of HIV infected patients when VL is undetectable improves antibody response.
Hospital Clinic. Barcelona. Spain
Correspondence to Dr. Elisa García Vázquez,Servicio de Medicina Interna-Infecciones,Hospital Universitario Virgen de la Arrixaca,Ctra. Madrid-Cartagena
30120 El Palmar (Murcia)
Tel:00 34 968 36 95 00,Fax:00 34 968 36 96 78
E-mail:elisag@eresmas.net
[Abstract] Objective To assess antibody response to capsular polysaccharides after vaccination with 23-valent pneumococcal polysaccharide vaccine (PPV) compared to that of 7-valent conjugate vaccine (CV).Methods 149 HIV positive patients (nadir CD4 count≥200 cells/μl) were randomised into: a) PPV (n=75); or b) CV (n=74). Blood samples were obtained prior to and 4 weeks after vaccination and levels of pneumococcal capsule-specific IgG antibody were measured by an ELISA test. “Seroconversion” was defined as an increase in antibody titers >395 U/ml. End point was rate of seroconversion in each group. Results 65/149 patients (43.6%) were seroconverters. There was a trend to higher rate of seroconversion in PPV group (50.7%) than in CV group (36.5%) (P=0.08). In multivariate analysis, factors associated with increased rate of immunogenic response to vaccination included having received PPV (OR 2.75; 95% CI 1.27~5.93) and undetectable prevacunal viral load (VL) (OR 3.30; 95% CI 1.39~7.84). After vaccination, an increase in mean VL (2.42 log. vs 2.69;P=0.004) and in mean CD4 count (627 cells/μl vs. 679;P=0.03) were observed.Conclusions Rate of seroconversion to pneumococcal vaccine is higher in PPV group than in CV group in HIV positive patients with nadir CD4 count≥200 cells/μl (OR 2.75). Immunization of HIV infected patients when VL is undetectable improves antibody response.