Quantitative and qualitative antibody responses to immunization with the pneumococcal polysaccharide vaccine in HIV-infected patients after initiation of antiretroviral treatment: Results from a randomized clinical trial

Maria C. Rodriguez-Barradas, Jose A. Serpa, Iona M. Munjal, Daniel Mendoza, Adriana M. Rueda, Mahwish Mushtaq, Liise-anne Pirofski

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background. Pneumococcal vaccination is recommended for human immunodeficiency virus-infected (HIV+) persons; the best timing for immunization with respect to initiation of antiretroviral therapy (ART) is unknown. Methods. Double-blind, placebo-controlled trial in HIV+ with CD4<sup>+</sup> T cells/μL (CD4) ≥ 200 randomized to receive the 23-valent pneumococcal polysaccharide vaccine (PPV23) or placebo at enrollment, followed by placebo or PPV23, respectively, 9-12 months later (after ≥ 6 months of ART). Capsular polysaccharide-specific immunoglobin (Ig) G and IgM levels to serotypes 1, 3, 4, 6B, and 23F, and opsonophagocytic killing activity (OPA) to serotypes 6B and 23F were evaluated 1 month postvaccination. Results. One hundred seven subjects were enrolled, 72 (67.3%) were evaluable (36/group). Both groups had significant increases in pre- to 1-month postvaccination IgG levels, but negligible to IgM, and significant increases in OPA titers to serotype 6B but not to 23F. There were no significant differences between groups in serotype-specific IgM or IgG levels or OPA titers. For the combined groups, there was a significant correlation between serotype-specific IgG and OPA titers to 23F but not to 6B. There was no correlation between CD4, viral load and IgG responses. Conclusions. In HIV+ with CD4 ≥ 200, delaying PPV23 until ≥ 6 months of ART does not improve responses and may lead to missed opportunities for immunization.

Original languageEnglish (US)
Pages (from-to)1703-1711
Number of pages9
JournalJournal of Infectious Diseases
Volume211
Issue number11
DOIs
StatePublished - Jun 1 2015

Fingerprint

Pneumococcal Vaccines
Antibody Formation
Immunization
Randomized Controlled Trials
HIV
Immunoglobulin G
Immunoglobulin M
Placebos
Therapeutics
Viral Load
Polysaccharides
Vaccination
Serogroup
T-Lymphocytes

Keywords

  • antibody
  • antiretroviral treatment
  • HIV
  • pneumococcal capsular polysaccharides
  • pneumococcal vaccine

ASJC Scopus subject areas

  • Infectious Diseases
  • Immunology and Allergy

Cite this

Quantitative and qualitative antibody responses to immunization with the pneumococcal polysaccharide vaccine in HIV-infected patients after initiation of antiretroviral treatment : Results from a randomized clinical trial. / Rodriguez-Barradas, Maria C.; Serpa, Jose A.; Munjal, Iona M.; Mendoza, Daniel; Rueda, Adriana M.; Mushtaq, Mahwish; Pirofski, Liise-anne.

In: Journal of Infectious Diseases, Vol. 211, No. 11, 01.06.2015, p. 1703-1711.

Research output: Contribution to journalArticle

@article{ccb07f3bfc39423d819b07a8613e66d8,
title = "Quantitative and qualitative antibody responses to immunization with the pneumococcal polysaccharide vaccine in HIV-infected patients after initiation of antiretroviral treatment: Results from a randomized clinical trial",
abstract = "Background. Pneumococcal vaccination is recommended for human immunodeficiency virus-infected (HIV+) persons; the best timing for immunization with respect to initiation of antiretroviral therapy (ART) is unknown. Methods. Double-blind, placebo-controlled trial in HIV+ with CD4+ T cells/μL (CD4) ≥ 200 randomized to receive the 23-valent pneumococcal polysaccharide vaccine (PPV23) or placebo at enrollment, followed by placebo or PPV23, respectively, 9-12 months later (after ≥ 6 months of ART). Capsular polysaccharide-specific immunoglobin (Ig) G and IgM levels to serotypes 1, 3, 4, 6B, and 23F, and opsonophagocytic killing activity (OPA) to serotypes 6B and 23F were evaluated 1 month postvaccination. Results. One hundred seven subjects were enrolled, 72 (67.3{\%}) were evaluable (36/group). Both groups had significant increases in pre- to 1-month postvaccination IgG levels, but negligible to IgM, and significant increases in OPA titers to serotype 6B but not to 23F. There were no significant differences between groups in serotype-specific IgM or IgG levels or OPA titers. For the combined groups, there was a significant correlation between serotype-specific IgG and OPA titers to 23F but not to 6B. There was no correlation between CD4, viral load and IgG responses. Conclusions. In HIV+ with CD4 ≥ 200, delaying PPV23 until ≥ 6 months of ART does not improve responses and may lead to missed opportunities for immunization.",
keywords = "antibody, antiretroviral treatment, HIV, pneumococcal capsular polysaccharides, pneumococcal vaccine",
author = "Rodriguez-Barradas, {Maria C.} and Serpa, {Jose A.} and Munjal, {Iona M.} and Daniel Mendoza and Rueda, {Adriana M.} and Mahwish Mushtaq and Liise-anne Pirofski",
year = "2015",
month = "6",
day = "1",
doi = "10.1093/infdis/jiu819",
language = "English (US)",
volume = "211",
pages = "1703--1711",
journal = "Journal of Infectious Diseases",
issn = "0022-1899",
publisher = "Oxford University Press",
number = "11",

}

TY - JOUR

T1 - Quantitative and qualitative antibody responses to immunization with the pneumococcal polysaccharide vaccine in HIV-infected patients after initiation of antiretroviral treatment

T2 - Results from a randomized clinical trial

AU - Rodriguez-Barradas, Maria C.

AU - Serpa, Jose A.

AU - Munjal, Iona M.

AU - Mendoza, Daniel

AU - Rueda, Adriana M.

AU - Mushtaq, Mahwish

AU - Pirofski, Liise-anne

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Background. Pneumococcal vaccination is recommended for human immunodeficiency virus-infected (HIV+) persons; the best timing for immunization with respect to initiation of antiretroviral therapy (ART) is unknown. Methods. Double-blind, placebo-controlled trial in HIV+ with CD4+ T cells/μL (CD4) ≥ 200 randomized to receive the 23-valent pneumococcal polysaccharide vaccine (PPV23) or placebo at enrollment, followed by placebo or PPV23, respectively, 9-12 months later (after ≥ 6 months of ART). Capsular polysaccharide-specific immunoglobin (Ig) G and IgM levels to serotypes 1, 3, 4, 6B, and 23F, and opsonophagocytic killing activity (OPA) to serotypes 6B and 23F were evaluated 1 month postvaccination. Results. One hundred seven subjects were enrolled, 72 (67.3%) were evaluable (36/group). Both groups had significant increases in pre- to 1-month postvaccination IgG levels, but negligible to IgM, and significant increases in OPA titers to serotype 6B but not to 23F. There were no significant differences between groups in serotype-specific IgM or IgG levels or OPA titers. For the combined groups, there was a significant correlation between serotype-specific IgG and OPA titers to 23F but not to 6B. There was no correlation between CD4, viral load and IgG responses. Conclusions. In HIV+ with CD4 ≥ 200, delaying PPV23 until ≥ 6 months of ART does not improve responses and may lead to missed opportunities for immunization.

AB - Background. Pneumococcal vaccination is recommended for human immunodeficiency virus-infected (HIV+) persons; the best timing for immunization with respect to initiation of antiretroviral therapy (ART) is unknown. Methods. Double-blind, placebo-controlled trial in HIV+ with CD4+ T cells/μL (CD4) ≥ 200 randomized to receive the 23-valent pneumococcal polysaccharide vaccine (PPV23) or placebo at enrollment, followed by placebo or PPV23, respectively, 9-12 months later (after ≥ 6 months of ART). Capsular polysaccharide-specific immunoglobin (Ig) G and IgM levels to serotypes 1, 3, 4, 6B, and 23F, and opsonophagocytic killing activity (OPA) to serotypes 6B and 23F were evaluated 1 month postvaccination. Results. One hundred seven subjects were enrolled, 72 (67.3%) were evaluable (36/group). Both groups had significant increases in pre- to 1-month postvaccination IgG levels, but negligible to IgM, and significant increases in OPA titers to serotype 6B but not to 23F. There were no significant differences between groups in serotype-specific IgM or IgG levels or OPA titers. For the combined groups, there was a significant correlation between serotype-specific IgG and OPA titers to 23F but not to 6B. There was no correlation between CD4, viral load and IgG responses. Conclusions. In HIV+ with CD4 ≥ 200, delaying PPV23 until ≥ 6 months of ART does not improve responses and may lead to missed opportunities for immunization.

KW - antibody

KW - antiretroviral treatment

KW - HIV

KW - pneumococcal capsular polysaccharides

KW - pneumococcal vaccine

UR - http://www.scopus.com/inward/record.url?scp=84930439837&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84930439837&partnerID=8YFLogxK

U2 - 10.1093/infdis/jiu819

DO - 10.1093/infdis/jiu819

M3 - Article

C2 - 25538270

AN - SCOPUS:84930439837

VL - 211

SP - 1703

EP - 1711

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

SN - 0022-1899

IS - 11

ER -