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HIV pneumococcal vaccination

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
BACKGROUND: Streptococcus pneumoniae is a leading and serious coinfection in adults with human immunodeficiency virus (HIV) infection, particularly in Africa. Prevention of this disease by vaccination with the current 23-valent polysaccharide vaccine is suboptimal. Protein conjugate vaccines offer a further option for protection, but data on their clinical efficacy in adults are needed. METHODS: In this double-blind, randomized, placebo-controlled clinical efficacy trial, we studied the efficacy of a 7-valent conjugate pneumococcal vaccine in predominantly HIV-infected Malawian adolescents and adults who had recovered from documented invasive pneumococcal disease...
September 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
Werner C Albrich, Michael W Pride, Shabir A Madhi, Jan Callahan, Peter V Adrian, Roger French, Nadia van Niekerk, Shite Sebastian, Victor Souza, Jean-Noel Telles, Glaucia Paranhos-Baccalà, Kathrin U Jansen, Keith P Klugman
BACKGROUND: A serotype-specific urinary antigen detection assay (UAD) for 13 serotypes included in the pneumococcal conjugate vaccine (PCV13) was recently reported as a useful diagnostic tool for pneumococcal pneumonia. We aimed to assess the diagnostic accuracy of the UAD in HIV-infected South African adults. METHODS: Urine specimens from a well-defined cohort of HIV-infected South African adults with pneumonia were evaluated retrospectively in the UAD assay. Pneumonia was considered pneumococcal if either sputum Gram stain, sputum culture, blood culture or immunochromatographic (ICT) BinaxNow® S...
November 9, 2016: Journal of Clinical Microbiology
Bikas K Arya, Sangeeta Das Bhattacharya, Catherine G Sutcliffe, Swapan Kumar Niyogi, Subhasish Bhattacharyya, Sunil Hemram, William J Moss, Samiran Panda, Ranjan Saurav Das, Sutapa Mandal, Dennis Robert, Pampa Ray
BACKGROUND: In addition to reducing Haemophilus influenzae type b (Hib) disease in vaccinated individuals, the Hib conjugate vaccine (HibCV) has indirect effects; it reduces Hib disease in unvaccinated individuals by decreasing carriage. Human immunodeficiency virus (HIV)-infected children are at increased risk for Hib disease and live in families where multiple members may have HIV. The aim of this study is to look at the impact of 2 doses of the HibCV on nasopharyngeal carriage of Hib in HIV-infected Indian children (2-15 years) and the indirect impact on carriage in their parents...
November 2016: Pediatric Infectious Disease Journal
Julia L Marcus, Roger Baxter, Wendy A Leyden, Dharushana Muthulingam, Arnold Yee, Michael A Horberg, Daniel B Klein, William J Towner, Chun R Chao, Charles P Quesenberry, Michael J Silverberg
It is unclear whether HIV-infected individuals remain at higher risk of invasive pneumococcal disease (IPD) compared with HIV-uninfected individuals. We conducted a cohort study of HIV-infected and demographically matched HIV-uninfected adults within Kaiser Permanente Northern California during the period 1996-2011. We used Poisson models to obtain rate ratios (RRs) for incident IPD associated with HIV infection and other risk factors. Among 13,079 HIV-infected and 137,643 HIV-uninfected adults, the IPD rate per 100,000 person-years was 160 (n = 109 events) for HIV-infected and 8 (n = 75 events) for HIV-uninfected subjects, with an adjusted RR of 13...
October 2016: AIDS Patient Care and STDs
Vijay G Mammen, Ziyaad Dangor, David P Moore, Alane Izu, Natalie Beylis, Shabir A Madhi
BACKGROUND: Children hospitalized with culture-confirmed pulmonary tuberculosis (PTB) frequently present with acute symptoms, possibly because of superimposed pneumococcal pneumonia. We undertook a time-series analysis to determine whether routine immunization of children with pneumococcal conjugate vaccine (PCV) was temporally associated with changes in the incidence of hospitalization for PTB in South African children. METHODS: PCV was introduced in the South African public immunization program in April 2009, with coverage for the third dose of PCV of 10%, 64% and 89% in 2009, 2010 and 2011, respectively...
October 12, 2016: Pediatric Infectious Disease Journal
Bahaa Abu-Raya, Tobias R Kollmann, Arnaud Marchant, Duncan M MacGillivray
Infants born to human immunodeficiency virus (HIV) infected women are HIV-exposed but the majority remains uninfected [i.e., HIV-exposed uninfected (HEU)]. HEU infants suffer greater morbidity and mortality from infections compared to HIV-unexposed (HU) peers. The reason(s) for these worse outcomes are uncertain, but could be related to an altered immune system state. This review comprehensively summarizes the current literature investigating the adaptive and innate immune system of HEU infants. HEU infants have altered cell-mediated immunity, including impaired T-cell maturation with documented hypo- as well as hyper-responsiveness to T-cell activation...
2016: Frontiers in Immunology
Michal Chowers, Gili Regev-Yochay, Orna Mor, Ronit Cohen-Poradosu, Klaris Riesenberg, Oren Zimhony, Daniel Chemtob, Michal Stein, Ron Dagan, Itzchak Levy
STUDY AIM: to assess the incidence, risk factors and outcome of invasive pneumococcal disease (IPD) among the Israeli HIV population. A matched case-control study nested in a nationwide, prospective, population-based, cohort of adult IPD was performed. In addition, the HIV-IPD patients were compared to the general adult HIV population in Israel. STUDY PERIOD: from the introduction of PCV into the national immunization program (NIP) in July 2009 to June 2014. Each HIV patient within the IPD cohort was matched to four non-HIV controls...
September 20, 2016: Human Vaccines & Immunotherapeutics
C Sadlier, S O'Dea, K Bennett, J Dunne, N Conlon, C Bergin
The aim of this study was to compare the immunologic response to a prime-boost immunization strategy combining the 13-valent conjugate pneumococcal vaccine (PCV13) with the 23-valent polysaccharide pneumococcal vaccine (PPSV23) versus the PPSV23 alone in HIV-infected adults. HIV-infected adults were randomized to receive PCV13 at week 0 followed by PPSV23 at week 4 (n = 31, prime-boost group) or PPSV23 alone at week 4 (n = 33, PPSV23-alone group). Serotype specific IgG geometric mean concentration (GMC) and functional oposonophagocytic (OPA) geometric mean titer (GMT) were compared for 12 pneumococcal serotypes shared by both vaccines at week 8 and week 28...
September 1, 2016: Scientific Reports
Gilmara Holanda da Cunha, Marli Teresinha Gimeniz Galvão, Camila Martins de Medeiros, Ryvanne Paulino Rocha, Maria Amanda Correia Lima, Francisco Vagnaldo Fechine
Antiretroviral therapy has increased the survival of patients with HIV/AIDS, thus necessitating health promotion practice with immunization. Vaccines are critical components for protecting people living with HIV/AIDS (PLWHA). The purpose of study was to analyze the vaccination status of PLWHA in outpatient care in Fortaleza, Ceará, Brazil. Cross-sectional study performed from June 2014 to June 2015. The screening was done with patients in antiretroviral therapy, 420 patients underwent screening, but only 99 met the inclusion criteria...
September 2016: Brazilian Journal of Infectious Diseases
Francesca Chiodi
No abstract text is available yet for this article.
July 31, 2016: AIDS
Jennifer R Verani, Michelle J Groome, Heather J Zar, Elizabeth R Zell, Constant N Kapongo, Susan A Nzenze, Christine Mulligan, David P Moore, Cynthia G Whitney, Shabir A Madhi
BACKGROUND: Pneumonia is a leading cause of child morbidity and death. Data on risk factors can guide prevention efforts. Within a study on pneumococcal conjugate vaccine effectiveness, we investigated risk factors for presumed bacterial pneumonia (PBP). METHODS: PBP cases were HIV-uninfected children with lower respiratory tract infection and consolidation on chest radiograph or non-consolidated infiltrate with C-reactive protein >40 mg/L hospitalized at Chris Hani Baragwanath Academic Hospital (CHBAH) in Soweto...
June 7, 2016: Pediatric Infectious Disease Journal
Francesca Lombardi, Simone Belmonti, Massimiliano Fabbiani, Matteo Morandi, Barbara Rossetti, Giacinta Tordini, Roberto Cauda, Andrea De Luca, Simona Di Giambenedetto, Francesca Montagnani
OBJECTIVES: Definition of the optimal pneumococcal vaccine strategy in HIV-infected adults is still under evaluation. We aimed to compare immunogenicity and safety of the 13-valent pneumococcal conjugate vaccine (PCV13) versus the 23-valent polysaccharide vaccine (PPSV23) in HIV-infected adults. METHODS: We performed a pilot, prospective controlled study enrolling HIV-infected pneumococcal vaccine-naïve outpatients, aged 18-65 years with CD4 counts ≥200 cells/μL...
2016: PloS One
Thad F Ocampo, Tuan Le, Peter E Matthews, Jason F Okulicz
Streptococcus pneumoniae infection is a predominant cause of bacterial infection in HIV-infected individuals. However, reported rates of pneumococcal vaccination with 23-valent polysaccharide vaccine (PPV23) are variable. We evaluated uptake of PPV23 in patients diagnosed with HIV between 1996 and 2012 (n = 507) in the United States Air Force, a centralized HIV program with free access to care including vaccines and medications. A total of 411 (81.1%) patients received at least 1 PPV23 dose. The PPV23 vaccination within 1 year of diagnosis was greater for those diagnosed between 2004 and 2012 (n = 184, 86%) compared with 1996 to 2003 (n = 104, 56...
July 2016: Journal of the International Association of Providers of AIDS Care
Theresa D Feola, Cynthia A Bonville, Donald A Cibula, Sherly Jose, Geetha Nattanmai, Joseph B Domachowske, Manika Suryadevara
BACKGROUND: Nasopharyngeal pneumococcal carriage rates among HIV-infected adults has not been described since conjugate pneumococcal vaccine-13 (PCV13) was added to the universal infant and childhood vaccination schedule in 2010. METHODS: HIV-infected adults presenting for routine health care visits to the Designated AIDS Center in Syracuse, NY between December 2013 and June 2015 were eligible for enrollment. Demographic, medical, and social history were recorded after obtaining informed consent...
September 2016: Human Vaccines & Immunotherapeutics
Alexandria E-B Rossheim, Anna Marie P Young, Julia Siik, Tina D Cunningham, Stephanie B Troy
INTRODUCTION: Pneumococcal infection is a leading cause of illness and death in HIV-infected adults. Current United States guidelines for HIV-infected adults recommend a single dose of the 13-valent pneumococcal conjugate vaccine (PCV-13) at any CD4 count and at least 1 y after receipt of the 23-valent pneumococcal polysaccharide vaccine (PPV). PPV is known to lead to hyporesponsiveness to subsequent pneumococcal vaccines for at least 1 y Whether PCV-13 would be more immunogenic if administered later after PPV receipt or at higher CD4 counts has not been tested...
August 2, 2016: Human Vaccines & Immunotherapeutics
Calman A MacLennan, Alex Richter, James Hodson, Sian Faustini, Jane Birtwistle, Alison Whitelegg, Joyful Chigiga, Mebie Singo, Jodie Walker-Haywood, Betselot Mulugeta, Sindiso Masuka, Chris Mainey, Tim Plant, Mark T Drayson, Kaveh Manavi
UK guidelines for vaccinating HIV-infected adults against bacteria are based on limited data. We compared antibody responses between 211 HIV-infected and 73 HIV-uninfected adults vaccinated with pneumococcal polysaccharide (PPV) and Hib/meningococcal C glycoconjugate vaccines (Hib/MenC-TT). IgG responses to Hib/MenC-TT were not significantly different. PPV induced IgGs >1.3 μg/ml for 10/12 serotypes among HIV-uninfected, and 5/12 in HIV-infected participants. HIV-uninfected adults had higher post-vaccination IgGs than HIV-infected for 4/12 serotypes (p<0...
May 7, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Jennifer A Ohtola, Jessica L Saul-McBeth, Anita S Iyer, David J Leggat, Sadik A Khuder, Noor M Khaskhely, Ma Julie Westerink
BACKGROUND: The number of aging human immunodeficiency virus-infected (HIV+) individuals living in the United States has substantially grown over the past two decades. Advanced age and HIV infection both increase susceptibility to Streptococcus pneumoniae infection due to B cell dysfunction. The combined impact of these factors on pneumococcal vaccine responses remains unknown. METHODS: We assessed serum immunoglobulin (Ig) G and IgM levels and opsonophagocytic killing assay (OPA) titers to pneumococcal serotypes 14 and 23F in HIV+ subjects and HIV-uninfected (HIV-) controls 50-65 years old...
March 2016: Journal of AIDS & Clinical Research
Sarah Eisen, Clare Hayden, Carmel J Young, Richard Gilson, Eva Jungmann, Marianne C Jacobsen, Hannah Poulsom, David Goldblatt, Nigel J Klein, Helen E Baxendale
OBJECTIVES: Many children with HIV infection now survive into adulthood. This study explored the impact of vertically acquired HIV in the era of antiretroviral therapy on the development of humoral immunity. DESIGN: Natural and vaccine-related immunity to pneumococcus and B-cell phenotype was characterized and compared in three groups of young adults: those with vertically-acquired infection, those with horizontally acquired infection and healthy controls. METHODS: Serotype-specific pneumococcal (Pnc) immunoglobulin M and G concentrations before and up to 1 year post-Pnc polysaccharide (Pneumovax) immunization were determined, and opsonophagocytic activity was analysed...
July 31, 2016: AIDS
Indhira De La Rosa, Iona M Munjal, Maria Rodriguez-Barradas, Xiaoying Yu, Liise-Anne Pirofski, Daniel Mendoza
HIV(+) subjects on optimal antiretroviral therapy have persistently impaired antibody responses to pneumococcal vaccination. We explored the possibility that this effect may be due to HIV protease inhibitors (PIs). We found that in humans and mice, PIs do not affect antibody production in response to pneumococcal vaccination.
June 2016: Clinical and Vaccine Immunology: CVI
Charles Feldman, Ronald Anderson
Opportunistic bacterial and fungal infections of the lower respiratory tract, most commonly those caused by Streptococcus pneumoniae (the pneumococcus), Mycobacterium tuberculosis, and Pneumocystis jirovecii, remain the major causes of mortality in those infected with human immunodeficiency virus (HIV). Bacterial respiratory pathogens most prevalent in those infected with HIV, other than M. tuberculosis, represent the primary focus of the current review with particular emphasis on the pneumococcus, the leading cause of mortality due to HIV infection in the developed world...
April 2016: Seminars in Respiratory and Critical Care Medicine
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