Pneumococcal Carriage Decreases Following Vaccination for Children With HIV
Vaccination changes serotype distribution from vaccine-type serotypes to nonvaccine-type serotypes.
Investigators found a decrease in pneumococcal carriage for children with HIV after a pneumococcal conjugate vaccine (PCV). The results of the study published in Clinical and Experimental Vaccine Research showed that vaccination also changed serotype distribution from vaccine-type serotypes to nonvaccine-type serotypes.1
Vaccination changes serotype distribution from vaccine-type serotypes to nonvaccine-type serotypes. | Image Credit: kittisak - stock.adobe.com
Pediatric patients can acquire HIV through perinatal transmission, which is the most common way patients under 13 years get the infection. The use of medication helped to lower the rate of transmission to 1% or less in the United States. Antiretroviral therapy is recommended for everyone with HIV, including pediatric patients. Treatment can be affected by growth and development in patients, such as a child’s weight, and some patients might need a liquid form instead of an oral medication. Adherence is a particularly important issue for patients with HIV, including children.2
Vaccination is recommended for children with HIV, and the recommended vaccination schedule corresponds with the Advisory Committee on Immunization Practices schedule for all children. Further, there are additions that are specific to children with an HIV infection. All inactivated vaccines can be administered to this patient population. In addition, children with HIV may also receive pneumococcal vaccines and Haemophilus influenzae type b vaccines beyond what is recommended for children without HIV. Further, additional vaccines, such as the pneumococcal polysaccharide vaccine for children aged 2 or older following the pneumococcal conjugate vaccine.3
In the current study, investigators aimed to investigate pneumococcal colonization, the serotype distribution, and the antimicrobial susceptibility for patients 6 years and older with HIV on pre- and post-single doses of PCV13. All patients received random treatment with either 1 dose of PCV13 or did not receive the vaccination. Investigators collected data before vaccination, 12 months post-vaccination, and 18 months post-vaccination.1
The results showed that 46% (n = 23/50) were colonized by S. pneumoniae, with a higher percentage in the vaccinated group at 56% compared with the control group at 36%. In the vaccinated group, there was a decrease in the prevalence of S. pneumoniae at 18% after 12 months compared to 46% pre-vaccination. Investigators stated that “colonization in the vaccinated group decreased from 56% (n=14/25) at pre-vaccination to 17% (n=4/23 subjects) at 12 months post-vaccination.”1
Furthermore, the prevalence was lower in the vaccinated group at 17% compared to 21% in the control group. At 18 months, the prevalence of colonization was higher at 26.1% in the vaccinated group compared to 12 months post-vaccination, though it was not statistically significant. Compared with the control group, the colonization was lower than the pre-vaccination period at 56%. Investigators reported that the colonization did not differ between the control and vaccinated groups pre- and post-vaccination.1
Vaccine-type serotypes were found more in the control group at 78% compared with the vaccinated group at 22%, but less in the vaccinated group at 36% compared to the control group at 64% pre-vaccine. Vaccine-type serotypes decreased in both the vaccinated and control groups, followed by an increase in nonvaccine-type serotypes in both groups at 12 months post-vaccination, according to the investigators.1
“There was a decrease in pneumococcal carriage after PCV13 vaccination in HIV-infected children, accompanied by changes in serotype distribution from [vaccine-type] to [nonvaccine-type],” investigators concluded.1 “The majority of pneumococcal isolates were less susceptible to oxacillin, tetracycline, and sulfamethoxazole-trimethoprim.”
READ MORE: Pneumococcal Resource Center
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