Antibodies against pneumococcal polysaccharides after vaccination in HIV-infected individuals: 5-year follow-up of antibody concentrations

A 5‐year longitudinal follow‐up study of serological responses to 23‐valent pneumococcal polysaccharide vaccination among patients with HIV infection who received highly active antiretroviral therapy*

“…However, most studies conducted in patients not receiving HAART suggest that HIV-infected patients have a significantly lower frequency and magnitude of antibody response to vaccination with 23-valent PPV than those without HIV infection, and antibody titres [immunoglobulin G (IgG) or IgM] appear to be associated with CD4 cell count and decrease more rapidly in HIV-infected patients [14][15][16][17][18][19][20][21][22]. Interpretation of studies conducted in the HAART era is limited by different durations of and immunological and virological responses to HAART, different vaccination schedules and short-term observation of antibody responses [23][24][25][26][27]. Whether receipt of HAART may improve antibody responses to 23-valent PPV in HIV-infected patients in longterm follow-up whose CD4 cell counts continue to increase has rarely been investigated.…”

“…The discrepancy may result from enrolment of subjects with different degrees of immunosuppression, use of different vaccination schedules or vaccines (polysaccharide vs. conjugated vaccine) [22,24,37,38], receipt of different types of antiretroviral therapy (mono or dual antiretroviral therapy vs. HAART) [23,[25][26][27]36,38], different immunological or virological responses to HAART, and different durations of observation. In this study we used a single dose of 23-valent PPV and the overall response rate was estimated to be 50% for those patients with CD4 counts of !…”

“…200 cells/mL who were antiretroviralnaïve or were receiving HAART [26,27,[36][37][38]; or have compared the serological responses of patients with CD4 counts of o200 cells/mL at vaccination with those of patients with CD4 counts of ! 200 cells/mL at vaccination [23][24][25]. Findings from those studies performed in the era of HAART regarding the correlation between CD4 cell count at vaccination and serological responses are inconsistent, however [23][24][25].…”

“…200 cells/mL at vaccination [23][24][25]. Findings from those studies performed in the era of HAART regarding the correlation between CD4 cell count at vaccination and serological responses are inconsistent, however [23][24][25]. In this study, we found that having a CD4 count of o100 cells/mL at vaccination, not o200 cells/mL, was associated with a significantly lower antibody response; and, despite similar increases in absolute CD4 cell counts after HAART, a faster loss of antibody response was observed in the group with CD4o100 cells/mL than in the other three groups during the 5 years of follow-up.…”

Pneumococcal vaccination among HIV-infected adult patients in the era of combination antiretroviral therapy

“…Despite the renumeration of CD4 counts with cART, several studies have shown that most patients failed to maintain durable antibody response for most serotypes following vaccination with PPV23 over the 5-year follow-up period, especially those who had low CD4 counts at vaccination and uncontrolled HIV replication. 38,42,43 Moreover, in HIV-infected patients receiving long-term cART who had received primary vaccination with PPV23 5 y earlier, revaccination with PPV23 elicited significantly poorer antibody responses than revaccination with one or 2 doses of 7-valent pneumococcal conjugate vaccines (PCV7). 41 Pneumococcal conjugate vaccines (PCVs), wherein conjugation of the capsular polysaccharide to a protein carrier converts the polysaccharide into a T cell-dependent antigen, have been shown to protect against IPD in HIV-infected children 44 and recurrent IPD in HIV-infected Malawian adolescents and adults.…”