Recurrent invasive pneumococcal disease in individuals with human immunodeficiency virus infection

McEllistrem, M. Catherine; Mendelsohn, Aaron B.; Pass, Margaret A.; Elliott, John A.; Whitney, Cynthia G.; Kolano, John A.; Harrison, Lee H.
May 2002
Journal of Infectious Diseases;5/1/2002, Vol. 185 Issue 9, p1364
Academic Journal
journal article
The proportion of relapses and reinfections that are potentially preventable by vaccine in human immunodeficiency virus (HIV)-infected persons with recurrent pneumococcal disease is unknown. Isolates from HIV-infected individuals from Baltimore with recurrent pneumococcal invasive disease were collected from 1 January 1995 through 31 December 2000. Serotyping and pulsed-field gel electrophoresis were performed. From 1 January 1995 through 31 December 1998, 14.9% (404/2717) of those who had a pneumococcal infection were HIV infected. The recurrence rate among HIV-infected individuals was 6.4-fold higher than that among individuals without HIV infection (P<.01). Among recurrent infections in 41 individuals, there were 42 reinfections and 6 relapses. All relapses and 91% (70/77) of reinfections were due to serotypes covered by the 23-valent pneumococcal polysaccharide vaccine. Reinfection was more common than relapse among HIV-infected individuals with recurrent pneumococcal disease. Although a substantial proportion of recurrent pneumococcal infections was potentially preventable by vaccine, creating an effective vaccine may be challenging for this population.


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