Longitudinal study on Streptococcus pneumoniae , Haemophilus influenzae and Staphylococcus aureus nasopharyngeal colonization in HIV-infected and -uninfected infants vaccinated with pneumococcal conjugate vaccine

• Published in: Vaccine Vol. 33; no. 23; pp. 2662 - 2669
• Main Authors: Madhi, Shabir A, Izu, Alane, Nunes, Marta C, Violari, Avye, Cotton, Mark F, Jean-Philippe, Patrick, Klugman, Keith P, von Gottberg, Anne, van Niekerk, Nadia, Adrian, Peter V
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 28.05.2015; Elsevier Limited
• Subjects: Age; Allergy and Immunology; Antiretroviral agents; Carrier State - epidemiology; Carrier State - microbiology; Colonization; Confidence intervals; Disease; Female; Haemophilus Infections - epidemiology; Haemophilus Infections - microbiology; Haemophilus influenzae; Haemophilus influenzae - isolation & purification; Heptavalent Pneumococcal Conjugate Vaccine - administration & dosage; HIV; HIV exposure; HIV Infections - complications; Human immunodeficiency virus; Humans; Immunization; Infant; Infant, Newborn; Infants; Longitudinal Studies; Lymphocytes; Male; Meningitis; Nasopharynx - microbiology; Pneumococcal conjugate vaccine; Pneumococcal Infections - epidemiology; Pneumococcal Infections - microbiology; Pneumonia; Prevalence; Public health; Staphylococcal Infections - epidemiology; Staphylococcal Infections - microbiology; Staphylococcus aureus; Staphylococcus aureus - isolation & purification; Staphylococcus infections; Streptococcus infections; Streptococcus pneumoniae; Streptococcus pneumoniae - isolation & purification; Studies; Vaccines; Pneumococcal conjugate vaccine; HIV; HIV exposure; Haemophilus influenzae; Staphylococcus aureus; Colonization; Streptococcus pneumoniae
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2015.04.024

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 with 7-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.