Response to Pneumococcal Polysaccharide Vaccination in Newly Diagnosed HIV-Positive Individuals
- *Corresponding Author:
- Westerink MA Julie
Health Education Building 211
University of Toledo Health Science Campus
3000 Arlington Ave, Toledo
E-mail: [email protected]
Received date: November 10, 2014; Accepted date: January 13, 2015; Published date: January 23, 2015
Citation: Leggat DJ, Iyer AS, Ohtola JA, Kommoori S, Duggan JM, et al. (2015) Response to Pneumococcal Polysaccharide Vaccination in Newly Diagnosed HIVPositive Individuals. J AIDS Clin Res 6: 419. doi:10.4172/2155-6113.1000419
Copyright: © 2015 Leggat DJ, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Newly diagnosed HIV-positive individuals are 35 to 100-fold more susceptible to Streptococcus pneumoniae infection compared to non-infected individuals. Therefore, the 23-valent pneumococcal polysaccharide vaccine (PPV23) has previously been recommended, though efficacy and effectiveness of vaccination remains controversial. Early severe B cell dysfunction is a central feature of HIV infection. The specific nature of the immune cells involved in the production of protective antigen-specific antibodies in HIV-positive individuals remains to be elucidated.
Objectives: Evaluate the antibody and antigen-specific B cell response to the 23-valent pneumococcal polysaccharide vaccine in newly diagnosed HIV-positive patients. Moreover, determine if newly diagnosed patients with CD4<200 cells/µl benefit from 6-12 months of HAART, allowing partial viral suppression and immune reconstitution, prior to immunization.
Methods: Newly diagnosed HIV-positive patients with CD4>200 cells/µl and CD4<200 cells/µl were immunized with PPV23. Patients with CD4<200 cells/µl received either immediate or delayed immunization following 6-12 months of HAART. Antibody responses, opsonophagocytic activity and phenotypic analysis of pneumococcal polysaccharidespecific B cells were studied.
Results: Newly diagnosed HIV-positive patients demonstrated CD4-dependent increases in antibody and opsonophagocytic titers thought to be commensurate with protection. Functional opsonophagocytic titers of patients with CD4<200 cells/µl immunized immediately compared to patients with CD4<200 cells/µl receiving HAART for 6-12 months were not significantly different. Pneumococcal polysaccharide-specific B cells were distributed evenly between IgM memory and switched memory B cells for all groups, but IgM memory B cells were significantly lower than in HIV-negative individuals.
Conclusions: Despite CD4-dependent pneumococcal polysaccharide-specific deficiencies in newly diagnosed HIV-positive patients, vaccination was beneficial based on opsonophagocytic titers for all newly diagnosed HIV-positive groups. In HIV-positive patients with CD4<200 cells/µl, 6-12 months of HAART did not improve opsonophagocytic titers or antibody concentrations. Based on these findings, immunization with the 23-valent pneumococcal polysaccharide vaccine should not be delayed in newly diagnosed HIV-positive patients with CD4<200 cells/µl.