Longitudinal study on Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus nasopharyngeal colonization in HIV-infected and -uninfected infants vaccinated with pneumococcal conjugate vaccine

Vaccine. 2015 May 28;33(23):2662-9. doi: 10.1016/j.vaccine.2015.04.024. Epub 2015 Apr 21.

Abstract

Background: Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus are all potentially pathogenic, which frequently colonize the nasopharynx (NP) prior to causing disease. We studied bacterial NP-colonization in 321 HIV-infected and 243 HIV-uninfected children vaccinated with 7-valent pneumococcal conjugate vaccine (PCV7) at 6, 10 and 14 weeks of age.

Methods: HIV-uninfected infants included those born to HIV-uninfected (HUU) and HIV-infected women (HEU); HIV-infected children with CD4+ lymphocyte ≥25% were randomized to initiate antiretroviral therapy immediately (ART-Immed) or when clinically indicated (ART-Def). Nasopharyngeal swabs for bacterial culture were taken prior to each PCV7 dose (Visits 1-3) and at 20, 39, 47 and 67 weeks of age (Visits 4-7). Swabs were cultured by standard methods and pneumococcal serotyping done by the Quellung method.

Results: Colonization patterns for pneumococcus, H. influenzae and S. aureus did not differ between HUU and HEU children; and were also generally similar between ART-Def and ART-Immed children. Prevalence of PCV7-serotype colonization was similar between HIV-infected and HIV-uninfected children, however, overall pneumococcal and specifically non-vaccine serotype colonization tended to be lower in HIV-infected children. HIV-infected children also had a 44% lower prevalence of S. aureus colonization at Visit-1 (p=0.010); and H. influenzae colonization was also lower among HIV-infected than HIV-uninfected children at Visit-2, Visit-3, Visit-6 and Visit-7.

Conclusion: Vaccine-serotype colonization is similar in PCV-immunized HIV-infected and HIV-uninfected children. We, however, identified a lower prevalence of overall-pneumococcal and H. influenzae colonization in HIV-infected children post-PCV vaccination, the clinical-relevance of which warrants further study.

Trial registration: ClinicalTrials.gov NCT00099658.

Keywords: Colonization; HIV; HIV exposure; Haemophilus influenzae; Pneumococcal conjugate vaccine; Staphylococcus aureus; Streptococcus pneumoniae.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carrier State / epidemiology*
  • Carrier State / microbiology
  • Female
  • HIV Infections / complications*
  • Haemophilus Infections / epidemiology*
  • Haemophilus Infections / microbiology
  • Haemophilus influenzae / isolation & purification
  • Heptavalent Pneumococcal Conjugate Vaccine / administration & dosage*
  • Humans
  • Infant
  • Infant, Newborn
  • Longitudinal Studies
  • Male
  • Nasopharynx / microbiology*
  • Pneumococcal Infections / epidemiology*
  • Pneumococcal Infections / microbiology
  • Prevalence
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / microbiology
  • Staphylococcus aureus / isolation & purification
  • Streptococcus pneumoniae / isolation & purification

Substances

  • Heptavalent Pneumococcal Conjugate Vaccine

Associated data

  • ClinicalTrials.gov/NCT00099658