Shabir A Madhi1, Alane Izu2, Marta C Nunes2, Avye Violari3, Mark F Cotton4, Patrick Jean-Philippe5, Keith P Klugman6, Anne von Gottberg7, Nadia van Niekerk2, Peter V Adrian2. 1. National Institute for Communicable Diseases - A Division of National Health Laboratory Service, Sandringham, South Africa; Department of Science/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa. Electronic address: madhis@rmpru.co.za. 2. Department of Science/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa. 3. University of Witwatersrand, Perinatal HIV Research Unit, Johannesburg, South Africa. 4. Children's Infectious Diseases Clinical Research Unit, Department of Paediatrics & Child Health, Faculty Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa. 5. Henry Jackson Foundation, Division of AIDS (HJF-DAIDS), A Division of The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Contractor to NIAID, NIH, DHHS, Bethesda, MD, United States. 6. Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa. 7. National Institute for Communicable Diseases - A Division of National Health Laboratory Service, Sandringham, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg, South Africa.
Abstract
BACKGROUND: Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus are all potentially pathogenic, which frequently colonize the nasopharynx (NP) prior to causing disease. We studied bacterial NP-colonization in 321 HIV-infected and 243 HIV-uninfected children vaccinated with7-valent pneumococcal conjugate vaccine (PCV7) at 6, 10 and 14 weeks of age. METHODS:HIV-uninfected infants included those born to HIV-uninfected (HUU) and HIV-infected women (HEU); HIV-infected children with CD4+ lymphocyte ≥25% were randomized to initiate antiretroviral therapy immediately (ART-Immed) or when clinically indicated (ART-Def). Nasopharyngeal swabs for bacterial culture were taken prior to each PCV7 dose (Visits 1-3) and at 20, 39, 47 and 67 weeks of age (Visits 4-7). Swabs were cultured by standard methods and pneumococcal serotyping done by the Quellung method. RESULTS: Colonization patterns for pneumococcus, H. influenzae and S. aureus did not differ between HUU and HEU children; and were also generally similar between ART-Def and ART-Immed children. Prevalence of PCV7-serotype colonization was similar between HIV-infected and HIV-uninfected children, however, overall pneumococcal and specifically non-vaccine serotype colonization tended to be lower in HIV-infected children. HIV-infected children also had a 44% lower prevalence of S. aureus colonization at Visit-1 (p=0.010); and H. influenzae colonization was also lower among HIV-infected than HIV-uninfected children at Visit-2, Visit-3, Visit-6 and Visit-7. CONCLUSION: Vaccine-serotype colonization is similar in PCV-immunized HIV-infected and HIV-uninfected children. We, however, identified a lower prevalence of overall-pneumococcal and H. influenzae colonization in HIV-infected children post-PCV vaccination, the clinical-relevance of which warrants further study.
RCT Entities:
BACKGROUND:Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus are all potentially pathogenic, which frequently colonize the nasopharynx (NP) prior to causing disease. We studied bacterial NP-colonization in 321 HIV-infected and 243 HIV-uninfectedchildren vaccinated with 7-valent pneumococcal conjugate vaccine (PCV7) at 6, 10 and 14 weeks of age. METHODS:HIV-uninfectedinfants included those born to HIV-uninfected (HUU) and HIV-infectedwomen (HEU); HIV-infectedchildren with CD4+ lymphocyte ≥25% were randomized to initiate antiretroviral therapy immediately (ART-Immed) or when clinically indicated (ART-Def). Nasopharyngeal swabs for bacterial culture were taken prior to each PCV7 dose (Visits 1-3) and at 20, 39, 47 and 67 weeks of age (Visits 4-7). Swabs were cultured by standard methods and pneumococcal serotyping done by the Quellung method. RESULTS: Colonization patterns for pneumococcus, H. influenzae and S. aureus did not differ between HUU and HEU children; and were also generally similar between ART-Def and ART-Immed children. Prevalence of PCV7-serotype colonization was similar between HIV-infected and HIV-uninfectedchildren, however, overall pneumococcal and specifically non-vaccine serotype colonization tended to be lower in HIV-infectedchildren. HIV-infectedchildren also had a 44% lower prevalence of S. aureus colonization at Visit-1 (p=0.010); and H. influenzae colonization was also lower among HIV-infected than HIV-uninfectedchildren at Visit-2, Visit-3, Visit-6 and Visit-7. CONCLUSION: Vaccine-serotype colonization is similar in PCV-immunized HIV-infected and HIV-uninfectedchildren. We, however, identified a lower prevalence of overall-pneumococcal and H. influenzae colonization in HIV-infectedchildren post-PCV vaccination, the clinical-relevance of which warrants further study.
Authors: D Bogaert; A van Belkum; M Sluijter; A Luijendijk; R de Groot; H C Rümke; H A Verbrugh; P W M Hermans Journal: Lancet Date: 2004-06-05 Impact factor: 79.321
Authors: I D Rusen; L Fraser-Roberts; L Slaney; J Ombette; M Lovgren; P Datta; J Ndinya-Achola; J A Talbot; N Nagelkerke; F A Plummer; J E Embree Journal: Pediatr Infect Dis J Date: 1997-07 Impact factor: 2.129
Authors: Courtney P Olwagen; Peter V Adrian; Marta C Nunes; Michelle J Groome; Mark F Cotton; Avy Violari; Shabir A Madhi Journal: mSphere Date: 2017-11-08 Impact factor: 4.389