Prevention of invasive pneumococcal disease among HIV-infected adults in the era of childhood pneumococcal immunization

被引：50

作者：

Cohen, Adam L. ^{[1
]}

Harrison, Lee H. ^{[4
,5
]}

Farley, Monica M. ^{[6
,7
]}

Reingold, Arthur L. ^{[8
]}

Hadler, James ^{[9
]}

Schaffner, William ^{[10
]}

Lynfield, Ruth ^{[11
]}

Thomas, Ann R. ^{[12
]}

Campsmith, Michael ^{[2
]}

Li, Jianmin ^{[2
]}

Schuchat, Anne ^{[3
]}

Moore, Matthew R. ^{[1
]}

机构：

[1] Ctr Dis Control & Prevent, Resp Dis Branch, Div Bacterial Dis, Atlanta, GA 30333 USA

[2] Ctr Dis Control & Prevent, Div HIV AIDS Prevent, Atlanta, GA 30333 USA

[3] Ctr Dis Control & Prevent, Natl Ctr Immunizat & Resp Dis, Atlanta, GA 30333 USA

[4] Johns Hopkins Bloomberg Sch Publ Hlth, Maryland Emerging Infect Program, Baltimore, MD USA

[5] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Baltimore, MD USA

[6] Emory Univ, Sch Med, Atlanta, GA USA

[7] Atlanta Vet Affairs Med Ctr, Atlanta, GA USA

[8] Univ Calif Berkeley, Sch Publ Hlth, Berkeley, CA 94720 USA

[9] Connecticut Emerging Infect Program, Hartford, CT USA

[10] Vanderbilt Univ, Sch Med, Dept Prevent Med, Nashville, TN 37212 USA

[11] Minnesota Dept Hlth, St Paul, MN USA

[12] Oregon Publ Hlth Div, Oregon Emerging Infect Program, Portland, OR USA

来源：

AIDS | 2010年 / 24卷 / 14期

关键词：

acquired immunodeficiency syndrome; HIV; opportunistic infections; pneumococcal vaccines; Streptococcus pneumoniae; HUMAN-IMMUNODEFICIENCY-VIRUS; ACTIVE ANTIRETROVIRAL THERAPY; CONJUGATE VACCINE; STREPTOCOCCUS-PNEUMONIAE; POLYSACCHARIDE VACCINE; UNITED-STATES; TRIAL; PREVALENCE; CARRIAGE; CHILDREN;

D O I：

10.1097/QAD.0b013e32833d46fd

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Objective: Human immunodeficiency virus (HIV) infection and AIDS increase the risk of invasive pneumococcal disease (IPD). We evaluated IPD among HIV-infected adults over a 10-year period in the US to identify opportunities for prevention of IPD among HIV-infected adults. Design: IPD and HIV surveillance in seven population-based and laboratory-based Active Bacterial Core surveillance areas. Methods: IPD cases were adults 18-64 years old with pneumococcus isolated from a normally sterile site during 1998-2007. Isolates were serotyped using the Quellung reaction. HIV/AIDS status was determined by medical record review. We calculated incidence of IPD among adults with AIDS using national case-based surveillance data. Results: Of 13 812 IPD cases among 18-64-year-olds, 3236 (23%) occurred among HIV-infected adults (with or without AIDS) and 1313 (10%) occurred among the subset of HIV-infected adults with AIDS. Compared with the period (1998-1999) before childhood 7-valent pneumococcal conjugate vaccine (PCV7) introduction in the US, the overall incidence of IPD among adults with AIDS decreased 25% from 399 to 298 cases per 100 000 by 2007 (P = 0.008). In 2006-2007, 8, 39 and 55% of IPD cases among adults with AIDS were caused by serotypes included in the 7-valent PCV, 13-valent PCV and 23-valent pneumococcal polysaccharide vaccines, respectively. Conclusion: Sustained declines in IPD have occurred among adults with AIDS in the US, but incidence remained high 7 years after PCV7 introduction. More aggressive efforts, including HIV-prevention measures and the use of new PCVs in children and possibly HIV-infected adults, are necessary to further reduce IPD among HIV-infected adults. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins

引用

页码：2253 / 2262

页数：10

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