Document 0153
 DOCN  M9580153
 TI    Should patients positive for HIV infection receive pneumococcal vaccine?
 DT    9506
 AU    Jain A; Jain S; Gant V; United Medical School of Guy's Hospital, London.
 SO    BMJ. 1995 Apr 22;310(6986):1060-2. Unique Identifier : AIDSLINE
       MED/95245225
 AB    Pneumococcal vaccination effectively reduces the incidence of invasive
       pneumococcal disease in normal subjects. Such invasive pneumococcal
       disease is 100 times more common in patients with HIV infection than in
       healthy people, so it seems logical to target this group of patients for
       vaccination. Few clinics routinely vaccinate patients positive for HIV,
       despite Department of Health guidelines. This is because of uncertainty
       about the vaccine's efficacy in HIV disease. There are many reasons to
       suspect that the vaccine will fail to protect these patients, including
       the fact that antibodies alone may not be sufficient protection against
       all serogroups of Pneumococcus and the vaccine works in healthy people
       but not immunocompromised subjects. Vaccination of HIV positive patients
       may not be indicated, at least for the time being. The cost of
       vaccinating such patients in the absence of data showing efficacy may
       well be less than the cost of a necessarily large and lengthy trial. But
       the truth must be sought to end current indecision.
 DE    Antibodies, Bacterial/BIOSYNTHESIS  AIDS-Related Opportunistic
       Infections/IMMUNOLOGY/*PREVENTION &  CONTROL  Bacterial
       Vaccines/*IMMUNOLOGY  Human  HIV Seropositivity/*IMMUNOLOGY
       Pneumococcal Infections/IMMUNOLOGY/*PREVENTION & CONTROL  Streptococcus
       pneumoniae/*IMMUNOLOGY  *Vaccination  JOURNAL ARTICLE  REVIEW  REVIEW,
       TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).