抗凝治疗肺心病血栓前状态的临床研究

目的探讨肺心病患者的血栓前状态，观察并分析低分子肝素抗凝干预的疗效。方法将54倒肺心病患者分为低分子肝素治疗组和常规治疗组各27例。分别检测治疗前后血浆血管性假血友病因子(VWF)、血浆凝血酶片段1 2(F1 2)、纤堆蛋白原(Fg)、血小板颗粒膜蛋白(GMP-140)和D-二聚体(DD)。结果肺心病患者VWF、F1 2、Fg、GMP-140、DD血浆浓度显著高于对照组；肺心病治疗组经LMWH治疗后上述各凝血分子标记物及PaCO2明显降低。而PaO2显著增高。常规组虽血气指标略有改善。但凝血分子标记物未见改善。结论尽早检测肺心病血栓前状态，及时给予低分子肝素抗凝干预，有望从根本上改善肺心病惠性加重期患者的不良预后。     

氟比洛芬酯自控镇痛对食管癌患者免疫功能和应激的影响

目的观察氟比洛芬酯复合芬太尼术后静脉自控镇痛对患者免疫功能和应激的影响。方法择期行食管癌根治术患者60例,随机分为3组（n=20）：F1组（术前氟比洛芬酯）、F2组（术后氟比洛芬酯）和C组（对照组）。分别在术后1、24、48h行视觉模拟评分（VAS）,术前30min、术后1、2d采集患者静脉血栓测血浆去甲肾上腺素（NE）、促肾上腺皮质激素（ACTH〉、皮质醇（COS）、CD3^＋、CD4^＋、CD8^＋和CD4^＋／CD8^＋。结果（1）3组术后48hVAS评分比较差异无统计学意义（P〉0．05）;（2）NE：本后1d,F1组低于C组、F2组。ACTH：术后1d,F1组、F2组均低于C组;术后2d,F1组低于C组。COS：与术前相比均有明显增高。（3）CD3^＋T细胞：术后1d,F1组、F2组高于C组。CD4^＋T细胞：C组、R组在术后1d均有明显降低。CD4^＋／CD8^＋值：F1组在术后1d明显高于C组、F2组。结论氟比洛芬酯复合芬太尼用于术后镇痛,可降低患者术后应激水平、改善患者机体细胞免疫功能。     

抗乙型副伤寒沙门菌鞭毛抗原McAb的特性分析与初步应用

目的：通过对抗乙型副伤寒沙门菌鞭毛抗原单克隆抗体的特性分析，研制检测乙型副伤寒沙门菌的ELISA法，对副伤寒传染病进行早期诊断。方法：用杂交瘤技术制备单克隆抗体，并进行鉴定，用双抗体夹心ELISA建立检测乙型副伤寒沙门菌鞭毛抗原ELISA方法，对临床标本进行检测。结果：7株抗乙型副伤寒沙门菌鞭毛抗原的单克隆抗体IgG15株、IgG2a1株、IgG2b1株，均不与相关沙门菌、肠道菌反应，用菌体免疫制备的MeAb 3B5、3G12、7H1、2B5，与乙型副伤寒沙门菌、乙型副伤寒沙门菌鞭毛抗原反应，而用纯化的鞭毛抗原免疫制备的单克隆抗体1F4、5D3、3H7，只与乙型副伤寒沙门菌鞭毛抗原，385与7H1识别同一抗原表位，3B5、7H1与3G12、2B5相互识别不同抗原表位，1F4、5D3、3H7相互识别不同抗原表位。3B5包被、过氧化物酶（HRP）标记3G12建立双抗体夹心ELISA，鞭毛抗原、菌体的最低检出量分别为5ng／ml、10^5个／ml。检测159份献血员血清及70份发热待查血清为阴性，1份发热待查血清、9份血培养阳性患者血清为阳性。结论：用纯化的鞭毛抗原免疫制备的单克隆抗体不适于检测乙型副伤寒沙门菌，菌体免疫制备的单克隆抗体特异性强，建立的双抗体夹心ELISA法，可对乙型副伤寒进行早期诊断。     

ω-3多不饱和脂肪酸对危重症肠外营养病人凝血系统和炎性反应的影响

目的:观察ICU肠外营养病人凝血因子和炎性因子的变化以及ω-3多不饱和脂肪酸对活化激活的凝血因子、炎性因子的调控作用。方法:将30例需PN的危重症病人随机分为常规组和尤文组,连续3 d给予PN。分别检测两组治疗前和治疗后1、2和3 d血浆NF-κB、6-酮-前列腺素F1α、E-选择素、可溶性细胞间黏附分子、凝血酶-抗凝血酶复合物、凝血酶原片段F1+2、D-二聚体、血栓调节素等水平。结果:常规组病人营养支持后与营养支持前比较,血浆NF-κB、可溶性细胞间黏附分子、E-选择素水平明显增加(P0.05)。血浆6-酮-前列腺素F1α水平明显下降(P0.05)。尤文组营养支持后与支持前比较,血浆NF-κB、可溶性细胞间黏附分子、E-选择素水平明显下降(P0.05),血浆6-酮-前列腺素F1α均明显增加(P0.05)。常规组营养支持后与营养支持前比较,血浆血栓调节素、凝血酶原片段F1+2、凝血酶-抗凝血酶复合物和D-二聚体明显增加(P0.05)。尤文组营养支持后与营养支持前比较,血浆血栓调节素、凝血酶原片段F1+2、凝血酶-抗凝血酶复合物及D-二聚体明显降低(P0.05)。结论:ω-3多不饱和脂肪酸具有抑制炎性反应,改善凝血紊乱的作用。     

抗黄曲霉毒素M1抗体制备及检测方法建立

目的制备针对黄曲霉毒素M1的单克隆抗体并建立针对黄曲霉毒素M1的间接竞争酶联免疫吸附试验检测方法。方法利用B细胞杂交瘤技术。建立能分泌抗黄曲霉毒素M1单克隆抗体的杂交瘤细胞株，制备抗黄曲霉毒素M1单克隆抗体，建立间接竞争酶联免疫吸附试验检测方法。结果研制出1株能特异性分泌抗黄曲霉毒素M1单克隆抗体的杂交瘤细胞株，命名为2F2。该单克隆抗体的Ig亚类为IgG1，亲和常数为2．8×10^-11mol／L。该抗体与黄曲霉毒素B1、黄曲霉毒素B2、黄曲霉毒素G1、黄曲霉毒素G2和黄曲霉毒素M2等结构类似物有微弱的交叉反应，具有较高的特异性。在此基础上建立了间接竞争酶联免疫吸附试验检测方法。该方法的最低检出浓度为0．07ng／ml。校正曲线的线性范围为0．02～2ng／ml，线性方程y=-0．4364x＋0．2693（R^2=0．9949）。方法的加标回收率为72．5％～131．3％。结论制备了具有高特异性和亲和力的抗黄曲霉毒素M1单克隆抗体，并建立了快速、灵敏的针对黄曲霉毒素M1的酶联免疫吸附试验检测方法。     

头颈部肿瘤患者放射治疗期间营养状况综合评价

目的构建营养评价综合模型,评价头颈部肿瘤患者放疗期间营养状况。方法用SPSS 17.0软件,根据患者营养状况建立综合评价模型。经因子分析确定了4个公因子F1、F2、F3、F4。结果建立的综合评价模型为：F=0.485F1＋0.236F2＋0.164F3＋0.115F4。将患者综合评分按四分位数分为4类：正常、轻度、中度、重度营养不良。结论利用因子分析得到的营养综合评价模型,能更全面反映患者营养状况,有利于早期发现营养不良,及时给予营养干预。     

溃疡性结肠炎患者凝血及抗凝标志物的变化及与血小板的相关性研究

目的探讨溃疡性结肠炎(UC)患者凝血标志物血浆纤维蛋白肽A(FPA)、凝血酶原片段1+2(F1+2)、抗凝标志物抗凝血酶-Ⅲ(AT-Ⅲ)的变化及与血小板的相关性。方法采用ELISA法检测40例活动期UC患者、20例缓解期UC患者及20例健康对照者的FPA、F1+2、AT-Ⅲ水平。结果血浆FPA、F1+2水平活动期UC患者高于缓解期UC及对照组,缓解期UC患者高于对照组,AT-Ⅲ水平活动期UC低于缓解期UC及对照组,缓解期UC患者低于对照组,各组比较差异有统计学意义(P<0.01);活动期UC患者随着疾病严重度加重血浆FPA、F1+2水平逐渐升高(P<0.05),血浆AT-Ⅲ水平逐渐下降,差异有统计学意义(P<0.01);随着病变范围扩大,血浆FPA、F1+2水平升高(P<0.05),血浆AT-Ⅲ水平下降(P<0.01)。结论 UC患者处于明显的血栓前状态,FPA、F1+2、AT-Ⅲ水平的变化与疾病活动性、疾病严重程度、病变累及范围及血小板数量有关。     

溃疡性结肠炎患者血浆FPA、F1+2、AT-Ⅲ的变化及相关性研究

目的:探讨溃疡性结肠炎(UC)患者血浆FPA、F1+2、AT-Ⅲ的变化及相关性。方法:采用ELISA法检测30例活动期UC患者、20缓解期UC患者及20例对照者的血浆纤维蛋白肽A(FPA)、凝血酶原片段1+2(F1+2)、抗凝血酶-Ⅲ(AT-Ⅲ)水平。结果:血浆FPA、F1+2水平活动期UC高于缓解期UC及对照组、缓解期UC高于对照组;AT-Ⅲ水平活动期UC低于缓解期UC及对照组、缓解期UC低于对照组,各组比较差别有统计学意义(P<0.01);活动期UC患者随着疾病严重度加重及病变范围扩大,血浆FPA、F1+2水平升高(P<0.05)、血浆AT-Ⅲ水平下降,差别有统计学意义(P<0.01);FPA与AT-Ⅲ、F1+2与AT-Ⅲ的变化存在负相关(P<0.05)。结论:UC患者处于明显的血栓前状态,FPA、F1+2、AT-Ⅲ水平的变化与疾病活动性、疾病严重程度及病变累及范围有关。     

如何预防血栓相关性疾病（一）——血栓相关疾病的种类和治疗方法

全球范围内，由于动脉粥样血栓形成而导致的血管性死亡占了人群死亡的1／3～1／2。随着我国居民生活水平的提高，生活方式和饮食习惯也发生了巨大变化，血栓相关性疾病的发病率也不断升高。本期我们主要向您介绍血栓相关疾病的种类和治疗方法。下一期，我们还将为您介绍血栓相关性疾病的预防。     

血小板膜糖蛋白Ia-807基因多态性与急性心肌梗死的关系研究

目的通过检测急性心肌梗死患者及对照组人员的血小板膜糖蛋白Ia-807基因多态性，探讨该多态性与急性心肌梗死发病的关系。对象急性心肌梗死患者32例，均符合世界卫生组织关于急性心肌梗死的诊断标准。对照组32例（排除有冠心病、缺血性脑卒中及外周血管血栓疾病者）。方法血小板膜糖蛋白Ia-807基因多态性分析：（1）碘化钾法提取人基因组DNA；（2）多聚酶链反应（PCR）扩增目的基因片段；（3）酶切产物经2％琼脂糖凝胶电泳分离后，紫外灯下观察酶切结果。SPSS11．5软件分析数据。结果急性心肌梗死组血小板膜糖蛋白Ia-807TT＋Tc基因型携带者频率显著高于对照组。结论血小板膜糖蛋白Ia-807T等位基因可能是急性心肌梗死发病的独立遗传性危险因素。     

抗伏马菌素B_1单克隆抗体的制备及试剂盒的研制

目的为了能够快速检测粮谷类食品中伏马菌素B_1的污染水平,研制具有我国自主知识产权的针对伏马菌素B_1快速检测试剂盒。方法制备了能分泌抗伏马菌素B_1单克隆抗体的杂交瘤细胞株,建立了敏感、特异、快速的酶联免疫吸附试验检测方法,最终形成具有中国自主知识产权的伏马菌素B_1快速检测试剂盒。结果该试剂盒所用单克隆抗体的Ig亚类为IgG1,亲和常数为8·3×10-8mol/L。该抗体与其他结构类似物无明显交叉反应,具有较高的特异性。试剂盒对伏马菌素B_1最低检出限5ng/ml,标准曲线的线性范围(50~500ng/ml),回归方程^Y=-0·582X+1·793(r=0·99,P<0·05);对玉米作50ng/ml,200ng/ml和500ng/ml3个加标浓度的回收率在71·89%~112·95%之间;试剂盒在常温状态下有效期至少10个月;实验室内的变异系数和实验室间的变异系数均小于20%。     

Evaluation of Ginger (Zingiber officinale Roscoe) Bioactive Compounds in Increasing the Ratio of T-cell Surface Molecules of CD3+CD4+:CD3+CD8+ In-Vitro

The potential ability of ginger bioactive compounds in increasing the ratio of T-cell surface molecules of CD3+CD4+:CD3+CD8+ was investigated using dual tagging FITC and PE of monoclonal antibody anti-human with its fluorescence measured by flow cytometer. Oleoresin was extracted using sinkhole distillation technique. Its components namely, gingerol in fraction-1, shogaol in fraction 2 and zingeron in fraction-3 were separated by column vacuum chromatography method. The doses of oleoresin, gingerol, shogaol, and zingeron tested were 50, 100,150, 200, and 250 μg/ml. Lymphocytes (2x106 cell/ml) from human peripheral blood were isolated using ficoll density gradient technique, and cultured in the presence of the compounds in RPMI-1640 medium and phytohemaglutinin (PHA) mitogen for 96 h under normal conditions. Percentages of T-cell surface molecules (CD4+ and CD8+) were determined using dual-tagging FITC and PE fluorescents labeled on monoclonal antibody anti human. The fluorescence-labeled bands on the T-cell surface molecules were counted using flow cytometer. The experiment revealed that oleoresin and its three fractions increased the percentage of CD3+CD4+. The compound in fraction 3 of oleoresin at 200 μg/ml increased by the highest percentage of CD3+CD4+ of 9%, but slightly decreased the percentage of CD3+CD8+. These ginger bioactive compounds increased the ratio of CD3+CD4:CD3+CD8+ T-cells with the highest increment of 30% from effects of 200 μg/ml fraction 3 of oleoresin. This in vitro finding revealed that ginger bioactive compounds potentially increased cellular and humoral immune response. Further clinical studies are needed to confirm the benefits of these ginger bioactive compounds as a potential functional food for testing on HIV infected patients.     

HYALURONIC ACID INCREASES MOTILITY/INTRACELLULAR CA 2+ CONCENTRATION IN HUMAN SPERM IN VITRO

This study investigated the mechanisms of the stimulatory effect of hyaluronic acid on motility in human sperm in vitro. A method, involving the measurement of forward progression through an agarose gel, was used to measure sperm motility quantitatively. Changes in intracellular Ca 2+ concentrations in sperm were detected using the fluorescent dye Fluo-3. The effects of hyaluronic acid (6.5, 65, 650 ng/mL) and nifedipine (32 nM) on sperm motility were investigated. The effects of hyaluronic acid, nifedipine (32 nM), A23187 (32 µM), and a monoclonal antibody to human CD44 (1 µg/mL) on changes in intracellular CA 2+ concentrations were investigated. Hyaluronic acid significantly ( p <. 008) stimulated sperm motility and this was partially inhibited by nifedipine.A23187 significantly ( p <. 005) increased intracellular CA 2+ concentrations. Hyaluronic acid significantly ( p <. 04) increased intracellular Ca 2+ concentrations and this was inhibited by nifedipine and a monoclonal antibody to human CD44. Hyaluronic acid stimulated human sperm motility by increasing intracellular Ca 2+ concentration, partially via an influx of extracellular Ca 2+.     

卵巢癌患者外周血Th1/Th2细胞因子的变化趋势及其临床意义

目的:分析卵巢癌患者外周血Thl和Th2细胞的细胞因子变化,为其免疫治疗提供实验依据。方法:用刺激物刺激43例卵巢癌患者外周血CD3+T细胞增加细胞因子的表达,然后加入荧光标记的特异性抗细胞因子单克隆抗体,特异性抗体与抗原结合,最后应用流式细胞仪分析特异性细胞因子表达水平。用酶联免疫吸附法(ELISA)检测血清中相应的细胞因子水平,同时设正常对照组,以评价其水平变化趋势。结果:卵巢癌患者Thl型细胞因子干扰素-γ(IFN-γ)、白细胞介素-2(IL-2)、白细胞介素-12(IL-12)表达水平较正常对照组显著降低,Th2型细胞因子白细胞介素-4(IL-4)和白细胞介素-10(IL-10)表达水平较正常对照组升高,差异有统计学意义。肿瘤坏死因子-α(TNF-α)表达水平较正常对照组升高,差异有显著性。结论:卵巢癌患者Th2型细胞因子模式占优势,这可能是肿瘤细胞发生免疫逃逸,从而导致肿瘤的发生或者转移的原因之一。     

脓毒症患者外周血CD4+CD25+调节性T细胞水平与APACHEⅡ评分相关性的临床研究

目的 探讨脓毒症患者外周血CD4+CD25+调节性T细胞水平及其与疾病严重程度的相关性.方法 选取脓毒症患者36例,依据诊断标准分为脓毒症组10例、严重脓毒症组15例和脓毒性休克组11例,以健康志愿者5例作为对照组.于入ICU时抽取外周血,分离淋巴细胞,以藻红蛋白(PE)标记的抗人CD4和异硫氰酸荧光素(FTTC)标记的抗人CD25单克隆抗体标记细胞,流式细胞仪检测CD4+CD25+调节性T细胞含量.并结合各组不同时间点的急性生理学及慢性健康状况(APACHE)Ⅱ评分,分析CD4+CD25+调节性T细胞与APACHEⅡ评分的相关性.结果 脓毒症组、严重脓毒症组和脓毒性休克组外周血CD4+CD25+调节性T细胞含量[分别为(10.31±2.32)%、(14.27±3.33)%、(15.32±3.98)%]均较对照组[(5.48±0.98)%]显著增高(P＜0.05或＜0.01).各组CD4+CD25+调节性T细胞水平与APACHEⅡ评分呈明显正相关,相关系数分别为0.829(P=0.032)、0.868(P=0.021)、0.913(P=0.009),总相关系数为0.903(P=0.013).结论 脓毒症患者外周血CD4+CD25+调节性T细胞明显升高,且与疾病严重程度相关.     

Construction of recombinant targeting immunogens incorporating an HIV-1 neutralizing epitope into sites of differing conformational constraint.

2F5 is one of the very few monoclonal antibodies with the capacity to neutralize a wide spectrum of type 1 human immunodeficiency virus (HIV-1) strains and primary isolates. Constructing an immunogen that contains a conformational mimic of the epitope recognized by 2F5 could provide the means to induce a broadly neutralizing anti-HIV-1 antibody response. Thus, in an effort to create a targeted, adjuvant-independent immunogen able to induce a 2F5-like antibody response, the gp41 sequence recognized by 2F5 (ELDKWAS) was genetically incorporated into different regions of an antibody specific for a framework determinant on human leukocyte antigen (HLA)-DR. All constructs were expressed, secreted from Sf9 insect cells, and found to retain the anti-HLA-DR specificity of the parental antibody. Three of the four constructs in which the ELDKWAS sequence was incorporated into a beta-turn (BT)-like conformational site were recognized by the 2F5 antibody. In contrast, none of the five constructs with the same sequence incorporated into surface-exposed regions of helical turn had any detectable 2F5 reactivity. In addition to demonstrating the significant plasticity of several regions in the antibody molecule in terms of accepting foreign sequences without loss of expression or binding specificity, these results also suggest that the native epitope recognized by the 2F5 antibody may be more beta-turn-like than helical in conformation. Importantly, with respect to vaccine development, the 2F5-reactive antibody constructs represent candidate immunogens for the adjuvant-independent induction of an HIV-1, neutralizing 2F5-like antibody response in humans.     

实验性抗磷脂综合征小鼠CD4~+CD25~+调节性细胞及foxp3表达的变化

目的:观察实验性抗磷脂综合征(experimental anti-phospholipid antibody syndrome,EAPS)进展过程中小鼠CD4+CD25+调节性T细胞(CD4+CD25+Treg)数量和功能变化。方法:以重组人β2糖蛋白1(rhβ2GP1)主动免疫BALB/c小鼠建立实验性APS模型,免疫12周后检测抗β2糖蛋白1抗体(anti-β2-GP1)、抗心磷脂抗体(ACA)、流产率(%)、活化部分凝血活酶时间(aPTT)、血小板计数(PLT PBC)。以流式细胞术检测小鼠PBMC中CD4+CD25+Treg细胞频率,RT-PCR检测转录因子Foxp3 mRNA的表达水平。结果:模型小鼠anti-β2-GP1、aCL水平明显升高,aPTT延长,PLT PBC降低,流产率提高,差异有统计学意义(P0.05)。模型小鼠PBMC中foxp3基因表达在4周短暂高于对照组(P0.05),8周后随着APS进展开始逐渐降低,12周后明显低于对照组(P0.05)。PBMC中CD4+CD25+Treg细胞频率8周前与对照组相比差异无统计学意义(P0.05),12周后逐渐减少,明显低于对照组(P0.05)。结论:CD4+CD25+Treg数量和功能下降参与抗磷脂综合征的发病机制。     

Hypervariable antigenic region 1 of classical swine fever virus E2 protein impacts antibody neutralization

Envelope glycoprotein E2 of classical swine fever virus (CSFV) is the major antigen that induces neutralizing antibodies and confers protection against CSFV infection. There are three hypervariable antigenic regions (HAR1, HAR2 and HAR3) of E2 that are different between the group 1 vaccine C-strain and group 2 clinical isolates. This study was aimed to characterize the antigenic epitope region recognized by monoclonal antibody 4F4 (mAb-4F4) that is present in the group 2 field isolate HZ1-08, but not in the C-strain, and examine its impact on neutralization titers when antisera from different recombinant viruses were cross-examined. Indirect ELISA with C-strain E2-based chimeric proteins carrying the three HAR regions showed that the mAb-4F4 bound to HAR1 from HZ1-08 E2, but not to HAR2 or HAR3, indicating that the specific epitope is located in the HAR1 region. Of the 6 major residues differences between C-strain and field isolates, Glu713 in the HAR1 region of strain HZ1-08 is critical for mAb-4F4 binding either at the recombinant protein level or using intact recombinant viruses carrying single mutations. C-strain-based recombinant viruses carrying the most antigenic part of E2 or HAR1 from strain HZ1-08 remained non-pathogenic to pigs and induced good antibody responses. By cross-neutralization assay, we observed that the anti-C-strain serum lost most of its neutralization capacity to RecC-HZ-E2 and QZ-14 (subgroup 2.1d field isolate in 2014), and vice versa. More importantly, the RecC-HAR1 virus remained competent in neutralizing ReC-HZ-E2 and QZ-14 strains without compromising the neutralization capability to the recombinant C-strain. Thus, we propose that chimeric C-strain carrying the HAR1 region of field isolates is a good vaccine candidate for classical swine fever.     

抗T-2毒素单克隆抗体的制备及鉴定

目的:制备并鉴定抗T-2毒素单克隆抗体杂交瘤细胞株,以期为T-2毒素的快速检测提供有力的抗体工具。方法:采用琥珀酸酐法将T-2毒素活化为T-2HS,T-2HS在DCC与NHS作用下与牛血清白蛋白(BSA)或卵清白蛋白(OVA)偶联合成完全抗原。以T-2HS-BSA为抗原,免疫BALB/c小鼠,用ELISA筛选、建立分泌抗T-2毒素抗体的杂交瘤细胞株。测定单抗免疫球蛋白亚类及单抗效价,用间接竞争法检测单克隆抗体细胞株的特异性。结果:建立了1株稳定分泌抗T-2毒素抗体的杂交瘤细胞株T-1B3,该细胞株所分泌的单隆抗体Ig亚类为IgG1,ELISA检测结果表明抗T-2毒素抗体可以与T-2毒素发生特异性反应,工作浓度为1:6.5×104,IC50为3.6 ng/ml。该抗体与HT-2毒素的交叉反应为65.9%,与黄曲霉毒素无交叉。结论:制备出能分泌具有较高特异性和亲和力的抗T-2毒素单克隆抗体的杂交瘤细胞株。     

Safety and immunogenicity of 23-valent pneumococcal polysaccharide vaccine in HIV-1 infected former drug users

The immunogenicity of 23-valent pneumococcal polysaccharide vaccine was assessed in 57 HIV-1 infected former intravenous drug users and in 20 HIV-1 negative controls. The effect of vaccination on HIV-1 infection was studied in a subgroup of 38 patients, 60% of whom under highly active antiretroviral therapy (HAART). Antibody to capsular polysaccharides from Streptococcus pneumoniae serotypes 3, 4, 6B, 19F, 23 F, and changes in CD4+ count, HIV-1 RNA, proviral DNA and HIV-1 phenotype were measured in pre- and post-vaccination samples.Vaccinations were well-tolerated. The rate of responders was higher (P<0.05) in HIV-1 negative than in HIV-1 infected individuals. No difference in antibody response was found within HIV-1 infected patients stratified according to CD4+ counts. Post-vaccination antibody geometric mean concentrations (GMCs) to the five antigens were higher (P<0.05) than baseline in HIV-1 negative subjects, but not in HIV-1 positive individuals. Those with CD4+ >500 cells/mm(3) showed a significant increase of antibody against type 3 only. Immunisation caused no significant changes in CD4+ counts and in either plasma HIV-1 RNA nor proviral DNA levels. Pneumococcal vaccination does not induce virological or immunological deterioration in HIV infected patients, but the antibody response to a single dose of vaccine is poor.