Document 0880
 DOCN  M9650880
 TI    Deficient antipneumococcal polysaccharide responses in HIV-seropositive
       patients.
 DT    9605
 AU    Loeliger AE; Rijkers GT; Aerts P; Been-Tiktak A; Hoepelman AI; van Dijk
       H; Borleffs JC; University Hospital Utrecht, Department of Internal
       Medicine, The; Netherlands.
 SO    FEMS Immunol Med Microbiol. 1995 Sep;12(1):33-41. Unique Identifier :
       AIDSLINE MED/96128450
 AB    In a prospective study, serological responses and opsonic activity
       towards Streptococcus pneumoniae were measured in 60 HIV-infected
       patients and 25 controls after the administration of the 23-valent
       pneumococcal vaccine (PneumovaxR). Serum samples were collected before
       vaccination and at weeks 1, 2, 4, and 12 after vaccination and were
       tested for the presence of antibodies against a mixture of capsular
       polysaccharide antigens (pool) and against type 3 and type 4 antigens
       (PS3 and PS4), using an ELISA. A serological response was defined as a
       two-fold or greater increase in serum titer after vaccination.
       Opsonophagocytosis was measured in patients with a definite response
       against PS3. Generally, prevaccination antipneumococcal antibody titers
       were clearly higher in HIV-infected patients than in healthy controls.
       After vaccination, antipool antibody responses were found in 76% of
       vaccinated patients; 24% of the patients were non-responders. In
       patients with more than 0.300 x 10(9) CD4 + cells per liter the
       percentage of responders was 94%; in patients with fewer than 0.300 x
       10(9) CD4 + cells per liter this percentage was 68% (P < 0.05). The
       antipool response in control subjects was 92%. A serological response to
       PS3 and PS4 was found in 29% and 49% of the patients, respectively, and
       was correlated with CD4 + cell count. In controls, these percentages
       were 48% and 92%, respectively. In 30% of responding patients, antibody
       titers dropped already to prevaccination levels by week 12 after
       vaccination. Opsonophagocytosis was not significantly improved by
       vaccination, probably because of a relatively high preexisting opsonic
       activity. Although prevaccination conditions may have had an important
       influence on the study outcome, the results are not in favor of a
       significant beneficial effect of vaccination with PneumovaxR on antibody
       formation in HIV-infected patients. This raises further questions as to
       the relevance of pneumococcal vaccination in this population.
 DE    Antibodies, Bacterial/*BIOSYNTHESIS/BLOOD/*IMMUNOLOGY  Antigens,
       Bacterial/IMMUNOLOGY  Human  HIV Seropositivity/BLOOD/*IMMUNOLOGY
       Opsonins  Phagocytosis/IMMUNOLOGY  Polysaccharides,
       Bacterial/ADMINISTRATION & DOSAGE/*IMMUNOLOGY  Prospective Studies
       Streptococcus pneumoniae/*IMMUNOLOGY  JOURNAL ARTICLE

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