Responsiveness of human immunodeficiency virus type 1-infected Kenyan women with or without prior pneumococcal disease to pneumococcal vaccine.

In East Africa, Streptococcus pneumoniae is a common and serious, but potentially preventable, human immunodeficiency virus type 1 (HIV-1)-associated pathogen. For 54 HIV-1-infected women, baseline levels of capsule-specific antibody to 2 of 4 pneumococcal serotypes were lower than levels in 15 seronegative women (P < .05). After immunization, specific antibody to all 4 serotypes increased in HIV-1-infected and -uninfected women (P < .05). Convalescent levels for 2 of 4 serotypes were greater in seronegative women, but the levels were not different between HIV-1-infected women with (n = 21) or without (n = 33) prior invasive pneumococcal disease. The baseline functional activity to kill S. pneumoniae type 14 was lower in HIV-1-infected than -uninfected women but also rose significantly in all groups after immunization. It is concluded that HIV-1 infection in Kenyan women is associated with decreased levels of natural antibody to selected pneumococcal capsular serotypes, but the vaccine is immunogenic in these patients who are at high risk of invasive pneumococcal disease.