EFFECT OF HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 INFECTION ON THE ANTIBODY-RESPONSE TO A GLYCOPROTEIN CONJUGATE PNEUMOCOCCAL VACCINE - RESULTSFROM A RANDOMIZED TRIAL

Adults (n = 282) were randomized to receive either a pneumococcal glyc oprotein conjugate vaccine, composed of pneumococcal serotypes 6B, 14, 18C, 19F, and 23F linked to CRM(197), or a 23-valent pneumococcal pol ysaccharide vaccine. Among human immunodeficiency virus (HIV)-uninfect ed persons, conjugate vaccine elicited significantly higher IgG antibo dy geometric mean titers (GMTs) than did polysaccharide vaccine for se rotypes 6B, 18C, and 23F: IgG GMTs were 9.0 versus 4.8, 23.2 versus 5. 9, and 15.3 versus 4.4 mu g/mL, respectively. In contrast, the two vac cines elicited similar antibody GMTs in HIV-infected persons: GMTs ran ged from 1.3 to 10.8 mu g/mL for all serotypes. Of note, among persons receiving polysaccharide vaccine, antibody GMTs in HIV-uninfected and -infected persons with CD4 lymphocytes greater than or equal to 500/m u L were similar. These data underscore the importance of controlled c linical evaluations of newer pneumococcal vaccines in all highrisk gro ups for whom pneumococcal immunization is recommended and highlight th e need for early immunization of HIV-infected persons with currently a vailable polysaccharide vaccines.