A case-control study to investigate serological correlates of clinical failure of 23-valent pneumococcal polysaccharide vaccine in HIV-1-infected Ugandan adults

J Infect Dis. 2004 Aug 15;190(4):707-12. doi: 10.1086/421911. Epub 2004 Jul 16.


We have investigated the association between the concentration of anti-polysaccharide pneumococcal capsule-specific (anti-PS) immunoglobulin G and the killing activity, in serum, in invasive pneumococcal disease (IPD) events and response to 23-valent polysaccharide vaccine in human immunodeficiency virus (HIV)-infected Ugandans. Case patients with IPD had lower concentrations of anti-PS IgG before and after vaccination and before the IPD event (P<.01 for 5 [i.e., 4, 9V, 14, 18C, and 19F] of 6 serotypes assessed). After vaccination, case patients were less likely than were control subjects to develop detectable serum killing activity against the 2 serotypes tested--for 19F, this activity was detected in 16% of case patients versus 37% of control subjects (P=.08); for 23F, it was detected in 11% of case patients versus 40% of control subjects (P=.02). Thus, absolute concentration of anti-PS IgG and an attenuated response to polysaccharide are associated with risk of IPD in HIV-infected adults.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Bacterial / blood*
  • Case-Control Studies
  • HIV Infections / blood
  • HIV Infections / complications
  • HIV Infections / immunology*
  • HIV-1*
  • Humans
  • Immunoglobulin G / blood
  • Opsonin Proteins / blood
  • Pneumococcal Infections / blood
  • Pneumococcal Infections / complications
  • Pneumococcal Infections / immunology*
  • Pneumococcal Infections / prevention & control
  • Pneumococcal Vaccines / administration & dosage
  • Pneumococcal Vaccines / immunology*
  • Polysaccharides / immunology
  • Streptococcus pneumoniae / chemistry
  • Streptococcus pneumoniae / immunology*
  • Treatment Outcome
  • Uganda
  • Vaccination*


  • Antibodies, Bacterial
  • Immunoglobulin G
  • Opsonin Proteins
  • Pneumococcal Vaccines
  • Polysaccharides