Recurrent Invasive Pneumococcal Disease in Individuals with Human Immunodeficiency Virus Infection

The proportion of relapses and reinfections that are potentially preventable by vaccine in human immunodeficiency virus (HIV)-infected persons with recurrent pneumococcal disease is unknown. Isolates from HIV-infected individuals from Baltimore with recurrent pneumococcal invasive disease were colle...

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Bibliographic Details
Published in:The Journal of infectious diseases 2002-05, Vol.185 (9), p.1364-1368
Main Authors: McEllistrem, M. Catherine, Mendelsohn, Aaron B., Pass, Margaret A., Elliott, John A., Whitney, Cynthia G., Kolano, John A., Harrison, Lee H.
Format: Article
Language:English
Subjects:
Adult
AIDS
Antibacterial agents
Antibiotics. Antiinfectious agents. Antiparasitic agents
Biological and medical sciences
Child
Child, Preschool
Concise Communications
Epidemiology
Female
HIV
HIV infections
HIV Infections - complications
Human viral diseases
Humans
Infections
Infectious diseases
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Pneumococcal infections
Pneumococcal Infections - etiology
Preventive medicine
Recurrence
Reinfection
Relapse
Vaccination
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
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Summary:The proportion of relapses and reinfections that are potentially preventable by vaccine in human immunodeficiency virus (HIV)-infected persons with recurrent pneumococcal disease is unknown. Isolates from HIV-infected individuals from Baltimore with recurrent pneumococcal invasive disease were collected from 1 January 1995 through 31 December 2000. Serotyping and pulsed-field gel electrophoresis were performed. From 1 January 1995 through 31 December 1998, 14.9%(404/2717) of those who had a pneumococcal infection were HIV infected. The recurrence rate among HIV-infected individuals was 6.4-fold higher than that among individuals without HIV infection (P < .01). Among recurrent infections in 41 individuals, there were 42 reinfections and 6 relapses. All relapses and 91%(70/77) of reinfections were due to serotypes covered by the 23-valent pneumococcal polysaccharide vaccine. Reinfection was more common than relapse among HIV-infected individuals with recurrent pneumococcal disease. Although a substantial proportion of recurrent pneumococcal infections was potentially preventable by vaccine, creating an effective vaccine may be challenging for this population.
ISSN:0022-1899
1537-6613
DOI:10.1086/339882