Temporal Changes in Pneumococcal Colonization in HIV-infected and HIV-uninfected Mother-Child Pairs Following Transitioning From 7-valent to 13-valent Pneumococcal Conjugate Vaccine, Soweto, South Africa

J Infect Dis. 2015 Oct 1;212(7):1082-92. doi: 10.1093/infdis/jiv167. Epub 2015 Mar 17.

Abstract

Background: We investigated the impact of infant pneumococcal conjugate vaccine (PCV) immunization on pneumococcal colonization among human immunodeficiency virus (HIV)-infected and HIV-uninfected mother-child pairs.

Methods: Pneumococcal colonization was assessed in May 2010-February 2011 (period 1; 7-valent PCV era) and May 2012-April 2013 (period 2; 13-valent PCV era). Standard microbiological methods were used for pneumococcus isolation and serotyping.

Results: In children 0-12 years, PCV13-serotype colonization decreased from period 1 to period 2 among HIV-uninfected (adjusted odds ratio [OR], 0.32; 95% confidence interval [CI], .25-.40) and HIV-infected children (adjusted OR, 0.37; 95% CI, .28-.49), while there was an increase in nonvaccine serotype colonization. Decreases in PCV13-serotype colonization were observed in HIV-uninfected women (adjusted OR, 0.44; 95% CI, .23-.81), with a similar trend in HIV-infected women. HIV-infected compared to -uninfected women had higher prevalence of overall (20.5% vs 9.7% in period 1; 13.8% vs 9.7% in period 2) and PCV13-serotype colonization (8.7% vs 5.4% in period 1; 4.8% vs 2.0% in period 2), P < .04 for all observations.

Conclusions: Targeted PCV vaccination of African infants in a setting with high HIV prevalence was associated with PCV13-serotype colonization reduction, including among unvaccinated HIV-infected women.

Keywords: HIV; indirect effect; mother-infant pairs; nasopharyngeal colonization; pneumococcal conjugate vaccine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Child
  • Child, Preschool
  • Female
  • HIV Infections / complications
  • HIV Infections / epidemiology*
  • HIV Infections / immunology
  • Heptavalent Pneumococcal Conjugate Vaccine / immunology*
  • Humans
  • Infant
  • Mothers
  • Nasopharynx / microbiology
  • Pneumococcal Infections / epidemiology*
  • Pneumococcal Infections / immunology
  • Pneumococcal Infections / prevention & control
  • Pneumococcal Vaccines / immunology*
  • Prevalence
  • Serogroup
  • Serotyping
  • South Africa / epidemiology
  • Streptococcus pneumoniae / classification
  • Streptococcus pneumoniae / immunology*
  • Streptococcus pneumoniae / isolation & purification
  • Vaccination

Substances

  • 13-valent pneumococcal vaccine
  • Heptavalent Pneumococcal Conjugate Vaccine
  • Pneumococcal Vaccines