TY - JOUR
T1 - Immunogenicity of the 13-valent pneumococcal conjugate vaccine followed by the 23-valent pneumococcal polysaccharide vaccine in people living with HIV on combination antiretroviral therapy
AU - Garcia Garrido, Hannah M.
AU - Schnyder, Jenny L.
AU - Haydari, Beheshta
AU - Vollaard, Albert M.
AU - Tanck, Michael W. T.
AU - de Bree, Godelieve J.
AU - Meek, Bob
AU - Grobusch, Martin P.
AU - Goorhuis, Abraham
N1 - Funding Information: The authors would like to thank Anne Reiners (Department of Immunology, St Antonius Hospital, Nieuwegein, the Netherlands) for assistance with the laboratory assessments. In addition, the authors thank the nurses working at the Center for Tropical Medicine and Travel Medicine, Amsterdam UMC, for administration of vaccines. Lastly, the authors thank all the participants for their time and effort. This work was supported by a Dutch public research grant of ZonMW [award no. 522004005]. The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. In 2018, the Research Ethics Committee of the Amsterdam UMC, Location AMC, provided ethical clearance [NL65687.018.18]. Not applicable. Funding Information: This work was supported by a Dutch public research grant of ZonMW [award no. 522004005]. The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. Publisher Copyright: © 2022 The Author(s)
PY - 2022/8/1
Y1 - 2022/8/1
N2 - People living with HIV (PLWH) are at increased risk of pneumococcal infections compared with the general population. The objective of this study was to investigate the immunogenicity of the combined pneumococcal vaccination schedule in PLWH. In this prospective cohort study, adult PLWH on antiretroviral therapy and HIV-negative controls received the 13-valent pneumococcal conjugate vaccine (PCV13) at baseline followed by the 23-valent pneumococcal polysaccharide vaccine (PPSV23) at Month 2. Serotype-specific IgG levels of 24 vaccine serotypes were measured at Months 0, 2, 4, 6 and 12. The primary outcome was seroprotection at Month 4, defined as the proportion of patients with a post-immunisation IgG concentration of ≥1.3 μg/mL for ≥70% (17/24) of vaccine serotypes. Samples of 120 patients were analysed. Seroprotection at Month 4 was 49% (39/80) for PLWH and 82% (28/34) in controls. At Month 12, seroprotection had decreased to 23% (18/79) and 63% (22/35), respectively. Nadir CD4 count ≥200 cells/mm3, preserved kidney function and co-administration of the diphtheria–tetanus–polio (DTP) vaccine were associated with better seroprotection among PLWH. IgG levels both of PLWH and controls (all 24 vaccine serotypes) were significantly higher compared with baseline at all timepoints. Although IgG levels of all 24 vaccine serotypes increased significantly both in PLWH and controls, only a minority of PLWH achieved seroprotection after PCV13 followed by PPSV23. In addition, protective immunity waned rapidly. Further research into alternative vaccinations strategies for PLWH is needed, such as vaccination schedules with higher-valent pneumococcal vaccines. The DTP vaccine may augment pneumococcal vaccination responses.
AB - People living with HIV (PLWH) are at increased risk of pneumococcal infections compared with the general population. The objective of this study was to investigate the immunogenicity of the combined pneumococcal vaccination schedule in PLWH. In this prospective cohort study, adult PLWH on antiretroviral therapy and HIV-negative controls received the 13-valent pneumococcal conjugate vaccine (PCV13) at baseline followed by the 23-valent pneumococcal polysaccharide vaccine (PPSV23) at Month 2. Serotype-specific IgG levels of 24 vaccine serotypes were measured at Months 0, 2, 4, 6 and 12. The primary outcome was seroprotection at Month 4, defined as the proportion of patients with a post-immunisation IgG concentration of ≥1.3 μg/mL for ≥70% (17/24) of vaccine serotypes. Samples of 120 patients were analysed. Seroprotection at Month 4 was 49% (39/80) for PLWH and 82% (28/34) in controls. At Month 12, seroprotection had decreased to 23% (18/79) and 63% (22/35), respectively. Nadir CD4 count ≥200 cells/mm3, preserved kidney function and co-administration of the diphtheria–tetanus–polio (DTP) vaccine were associated with better seroprotection among PLWH. IgG levels both of PLWH and controls (all 24 vaccine serotypes) were significantly higher compared with baseline at all timepoints. Although IgG levels of all 24 vaccine serotypes increased significantly both in PLWH and controls, only a minority of PLWH achieved seroprotection after PCV13 followed by PPSV23. In addition, protective immunity waned rapidly. Further research into alternative vaccinations strategies for PLWH is needed, such as vaccination schedules with higher-valent pneumococcal vaccines. The DTP vaccine may augment pneumococcal vaccination responses.
KW - HIV
KW - Immunogenicity
KW - Pneumococcal disease
KW - Pneumococcal vaccination
KW - Vaccine
UR - http://www.scopus.com/inward/record.url?scp=85133622830&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ijantimicag.2022.106629
DO - https://doi.org/10.1016/j.ijantimicag.2022.106629
M3 - Article
C2 - 35760223
SN - 0924-8579
VL - 60
JO - International Journal of Antimicrobial Agents
JF - International Journal of Antimicrobial Agents
IS - 2
M1 - 106629
ER -