BACKGROUND: Adults infected with HIV have high rates of invasive pneumococcal disease. Introduction of pneumococcal conjugate vaccine for children could affect disease among HIV-infected adults. OBJECTIVE: To compare invasive pneumococcal disease among HIV-infected adults before and after the introduction of a pediatric conjugate vaccine. DESIGN: Active laboratory-based surveillance in an adult population of 10.8 million, including 38,314 living with AIDS. SETTING: 7 Active Bacterial Core surveillance areas in the United States. PATIENTS: All surveillance-area residents 18 to 64 years of age with Streptococcus pneumoniae isolated from a sterile site between 1998 and 2003. MEASUREMENTS: Ratio of the number of cases of invasive pneumococcal disease among HIV-infected adults to the estimated number of adults 18 to 64 years of age living with AIDS; serotype-specific subset analyses; and comparison of periods before and after introduction of conjugate vaccine by using exact tests. RESULTS: Of 8582 cases of invasive pneumococcal disease in adults, 2013 (24%) occurred among persons infected with HIV. Between baseline (1998 to 1999) and 2003, the ratio of invasive pneumococcal disease in HIV-infected adults to the number of adults living with AIDS in the surveillance areas decreased from 1127 to 919 cases per 100 000 AIDS population, a reduction of 19% (P = 0.002). Among HIV-infected adults, the ratio for disease caused by pneumococcal serotypes included in the conjugate vaccine decreased 62% (P < 0.001), although the ratio for disease caused by nonvaccine serotypes increased 44% (P < 0.001). LIMITATIONS: Ratios are proxy measures of incidence rates. The denominator of surveillance-area residents living with HIV infection was not available. CONCLUSIONS: Introduction of the pediatric conjugate vaccine was associated with an overall decrease in invasive pneumococcal disease among HIV-infected adults, despite increased disease caused by nonvaccine serotypes.
BACKGROUND: Adults infected with HIV have high rates of invasive pneumococcal disease. Introduction of pneumococcal conjugate vaccine for children could affect disease among HIV-infected adults. OBJECTIVE: To compare invasive pneumococcal disease among HIV-infected adults before and after the introduction of a pediatric conjugate vaccine. DESIGN: Active laboratory-based surveillance in an adult population of 10.8 million, including 38,314 living with AIDS. SETTING: 7 Active Bacterial Core surveillance areas in the United States. PATIENTS: All surveillance-area residents 18 to 64 years of age with Streptococcus pneumoniae isolated from a sterile site between 1998 and 2003. MEASUREMENTS: Ratio of the number of cases of invasive pneumococcal disease among HIV-infected adults to the estimated number of adults 18 to 64 years of age living with AIDS; serotype-specific subset analyses; and comparison of periods before and after introduction of conjugate vaccine by using exact tests. RESULTS: Of 8582 cases of invasive pneumococcal disease in adults, 2013 (24%) occurred among persons infected with HIV. Between baseline (1998 to 1999) and 2003, the ratio of invasive pneumococcal disease in HIV-infected adults to the number of adults living with AIDS in the surveillance areas decreased from 1127 to 919 cases per 100 000 AIDS population, a reduction of 19% (P = 0.002). Among HIV-infected adults, the ratio for disease caused by pneumococcal serotypes included in the conjugate vaccine decreased 62% (P < 0.001), although the ratio for disease caused by nonvaccine serotypes increased 44% (P < 0.001). LIMITATIONS: Ratios are proxy measures of incidence rates. The denominator of surveillance-area residents living with HIV infection was not available. CONCLUSIONS: Introduction of the pediatric conjugate vaccine was associated with an overall decrease in invasive pneumococcal disease among HIV-infected adults, despite increased disease caused by nonvaccine serotypes.
Authors: F M Russell; J R Carapetis; C Satzke; L Tikoduadua; L Waqatakirewa; R Chandra; A Seduadua; S Oftadeh; Y B Cheung; G L Gilbert; E K Mulholland Journal: Clin Vaccine Immunol Date: 2010-10-13
Authors: Susan S Huang; Virginia L Hinrichsen; Abbie E Stevenson; Sheryl L Rifas-Shiman; Ken Kleinman; Stephen I Pelton; Marc Lipsitch; William P Hanage; Grace M Lee; Jonathan A Finkelstein Journal: Pediatrics Date: 2009-07 Impact factor: 7.124
Authors: Neil French; Stephen B Gordon; Thandie Mwalukomo; Sarah A White; Gershom Mwafulirwa; Herbert Longwe; Martin Mwaiponya; Eduard E Zijlstra; Malcolm E Molyneux; Charles F Gilks Journal: Malawi Med J Date: 2016-09 Impact factor: 0.875
Authors: Heather E Hsu; Kathleen A Shutt; Matthew R Moore; Bernard W Beall; Nancy M Bennett; Allen S Craig; Monica M Farley; James H Jorgensen; Catherine A Lexau; Susan Petit; Arthur Reingold; William Schaffner; Ann Thomas; Cynthia G Whitney; Lee H Harrison Journal: N Engl J Med Date: 2009-01-15 Impact factor: 91.245