Hospitalizations for invasive pneumococcal disease among HIV-1-infected adolescents and adults in the United States in the era of highly active antiretroviral therapy and the conjugate pneumococcal vaccine.

We describe hospitalization trends of invasive pneumococcal disease (IPD) among HIV-infected adolescents and adults since the introduction of highly active antiretroviral therapy (HAART) and the 7-valent pneumococcal conjugate vaccine (PCV7) in the United States, using the nation-wide inpatient sample. We estimated national trends of IPD hospitalizations during 3 periods: 1994-1995 (pre-HAART/pre-PCV7); 1998-1999 (HAART/pre-PCV7); and 2004-2005 (HAART/ early PCV7). The number of IPD hospitalizations among HIV-infected individuals declined 49.2% between 1994/1995 and 2004/2005. Compared with 1994-1995, the adjusted odds ratio for IPD hospitalizations of HIV-infected adolescents and adults in the United States during 2004-2005 was 0.64 (95% confidence interval: 0.54 to 0.77). The decrease was observed after introduction of the PCV7.