OBJECTIVE: The effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV-23) in preventing pneumococcal disease in HIV-infected people is a subject of debate. We reviewed the clinical evidence for recommending PPV-23 for use in HIV-infected patients. METHODS: A systematic search of peer-reviewed publications (EMBASE, the Cochrane Library, and PubMed/BioMed Central), the Internet and grey literature was conducted. Three hundred and eighteen documents were reviewed. Studies reporting risk estimates for all-cause pneumonia, all-pneumococcal disease, and/or invasive pneumococcal disease after PPV-23 immunization in HIV-infected adults were included. RESULTS: We identified one randomized trial and 15 observational studies. While the randomized trial found a 60% increased risk of all-cause pneumonia among vaccinees, 11 of the 15 observational studies found various degrees of disease protection associated with PPV-23 immunization. However, most studies suffered from limited confounder control in their multivariate analyses, despite study data suggesting substantial differences between the characteristics of exposed and unexposed individuals. CONCLUSIONS: The current clinical evidence provides only moderate support for PPV-23 immunization of HIV-infected adults. More data are needed on the efficacy of newer conjugated pneumococcal vaccines, which may be more immunogenic and could potentially replace PPV-23 in the future.
OBJECTIVE: The effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV-23) in preventing pneumococcal disease in HIV-infected people is a subject of debate. We reviewed the clinical evidence for recommending PPV-23 for use in HIV-infectedpatients. METHODS: A systematic search of peer-reviewed publications (EMBASE, the Cochrane Library, and PubMed/BioMed Central), the Internet and grey literature was conducted. Three hundred and eighteen documents were reviewed. Studies reporting risk estimates for all-cause pneumonia, all-pneumococcal disease, and/or invasive pneumococcal disease after PPV-23 immunization in HIV-infected adults were included. RESULTS: We identified one randomized trial and 15 observational studies. While the randomized trial found a 60% increased risk of all-cause pneumonia among vaccinees, 11 of the 15 observational studies found various degrees of disease protection associated with PPV-23 immunization. However, most studies suffered from limited confounder control in their multivariate analyses, despite study data suggesting substantial differences between the characteristics of exposed and unexposed individuals. CONCLUSIONS: The current clinical evidence provides only moderate support for PPV-23 immunization of HIV-infected adults. More data are needed on the efficacy of newer conjugated pneumococcal vaccines, which may be more immunogenic and could potentially replace PPV-23 in the future.
Authors: Joshua M Wong; Leonard Cosmas; Dhillon Nyachieo; John M Williamson; Beatrice Olack; George Okoth; Henry Njuguna; Daniel R Feikin; Heather Burke; Joel M Montgomery; Robert F Breiman Journal: J Infect Dis Date: 2015-02-25 Impact factor: 5.226
Authors: Jennifer A Ohtola; Jessica L Saul-McBeth; Anita S Iyer; David J Leggat; Sadik A Khuder; Noor M Khaskhely; Ma Julie Westerink Journal: J AIDS Clin Res Date: 2016-03-14
Authors: Jennifer A Ohtola; Noor M Khaskhely; Jessica L Saul-Mcbeth; Anita S Iyer; David J Leggat; Sadik A Khuder; M A Julie Westerink Journal: Vaccine Date: 2015-12-18 Impact factor: 3.641