IGG ANTIBODY TO PNEUMOCOCCAL CAPSULAR POLYSACCHARIDE IN HUMAN IMMUNODEFICIENCY VIRUS-INFECTED SUBJECTS - PERSISTENCE OF ANTIBODY IN RESPONDERS, REVACCINATION IN NONRESPONDERS, AND RELATIONSHIP OF IMMUNOGLOBULIN ALLOTYPE TO RESPONSE

Human immunodeficiency virus (HIV)-infected persons are less likely th an are noninfected persons to respond to vaccination with pneumococcal polysaccharides (PPS). Among those who respond, however, similar IgG levels may be achieved. HIV-infected men immunized with pneumococcal v accine were classified as high- or low-level responders (IgG greater t han or equal to 1 mu g/mL for greater than or equal to 3 of 5 PPS [hig h] or for less than or equal to 1 PPS [low]). One and 2 years after im munization, geometric mean IgG levels and the percentages of subjects with IgG levels greater than or equal to 1 mu g/mL were similar for HI V-infected and for healthy high-level responders (controls) for all PP S except for serotype 8. Among HIV-infected low-level responders, reva ccination with a double dose of pneumococcal vaccine did not stimulate IgG responses. Responsiveness of HIV-infected white patients was sign ificantly associated with the Km(1)-negative allotype. These findings support current general recommended guidelines for administering pneum ococcal vaccine to HIV-infected persons. Nonresponders will not benefi t from revaccination.