The Effect of Chronic Cytomegalovirus Infection on Pneumococcal Vaccine Responses

• Published in: The Journal of infectious diseases 2014-05, Vol.209 (10), p.1635-1641
• Main Authors: O'Connor, Daniel, Trück, Johannes, Lazarus, Rajeka, Clutterbuck, Elizabeth A., Voysey, Merryn, Jeffery, Katie, Pollard, Andrew J.
• Format: Article
• Language: English
• Subjects: Age; Aged; Antibodies; Antibodies, Bacterial - blood; Applied microbiology; Bacterial diseases; Biological and medical sciences; Chronic Disease; Cytomegalovirus; Cytomegalovirus infections; Cytomegalovirus Infections - immunology; Cytomegalovirus Infections - pathology; Female; Fundamental and applied biological sciences. Psychology; HIV/AIDS; Human bacterial diseases; Humans; Immunoglobulin G - blood; Immunology; Infections; Infectious diseases; Influenza vaccines; Male; Medical sciences; Microbiology; Middle Aged; Older adults; Pneumococcal vaccines; Pneumococcal Vaccines - immunology; Staphylococcal infections, streptococcal infections, pneumococcal infections; Streptococcus pneumoniae; T lymphocytes; Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies (general aspects)
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jit673

Background. Immune function declines with age and has been associated with reduced vaccine responsiveness. Chronic infection with cytomegalovirus (CMV) has been proposed as a contributor to poorer responses in older adults. A pneumococcal vaccine has been recommended in the United Kingdom for those aged >65 years since 2003 to prevent pneumococcal disease. Methods. We evaluated the effect of age and CMV status on pneumococcal vaccine responses in 348 individuals aged 50-70 years. Results. We found participant age to be associated with serotype-specific and functional antibody titers after pneumococcal vaccination, with a mean 6.2% (95% confidence interval, 2.9%-9.5%) reduction in postvaccination functional antibody titers per year. CMV status was not associated with serotype-specific immunoglobulin G concentrations or functional antibody titers after pneumococcal vaccination. However, CMV seropositivity was associated with higher levels of prevaccination functional antibody for 4 of 7 pneumococcal serotypes assessed. Conclusions. These data imply that CMV infection is not directly responsible for the decline in pneumococcal vaccine responses seen with age but suggest that CMV-seropositive individuals differ in their natural exposure to pneumococci or have altered mucosal immune responses after colonization with this organism.