Evaluation of the impact of HIV-1 infection and density of common nasopharyngeal bacterial colonizers in South African children immunized with 7-valent pneumococcal conjugate vaccine |
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Institution: | 1. Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Faculty Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;2. Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;1. Unidad de Investigación Médica en Enfermedades Oncológicas, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico;2. Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA;3. Departamento de Patología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico;4. Fluidigm Canada Inc., Markham, ON, Canada;5. Division of Hematopathology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada;6. División de Ortopedia, Hospital de Traumatología y Ortopedia Lomas Verdes, Instituto Mexicano del Seguro Social, Mexico City, Mexico;7. Unidad de Reemplazo Articular, Hospital de Traumatología y Ortopedia Lomas Verdes, Instituto Mexicano del Seguro Social, Mexico City, Mexico;8. Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada;9. Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada;1. Department of Surgery, University of California, San Francisco, San Francisco, California, USA;2. Department of Nephrology, University of California, San Francisco, San Francisco, California, USA;3. Department of Pathology, University of California, San Francisco, San Francisco, California, USA;1. Division of Transplant Surgery, University of California San Francisco, San Francisco, California, USA;2. Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, California, USA;3. Laboratory of Experimental Nephrology and Transplantation, Institut d’Investigació Biomèdica de Bellvitge, Barcelona, Spain;4. Kidney Transplant Unit, Bellvitge University Hospital, Institut d’Investigació Biomèdica de Bellvitge, Barcelona, Spain;5. Pathology Department, Bellvitge University Hospital, Barcelona University, Institut d’Investigació Biomèdica de Bellvitge, Barcelona, Spain;6. Department of Pediatrics, University of California San Francisco, San Francisco, California, USA;1. Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia;2. The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia;3. Royal Melbourne Institute of Technology University - Bundoora Campus, Melbourne, Victoria, Australia;4. INRS-Institut Armand-Frappier, Laval, QC, Canada;5. BioMed Research Centre, Laval, QC, Canada Center for Interdisciplinary Research on Well-Being, Health, Society and Environment, Universite du Quebec a Montreal, Montreal, QC, Canada;6. Institut National de la Santé, et de la Recherche Médicale, Unité, 1036, Grenoble, France;7. Univ. Grenoble-Alpes, 38000, Grenoble, France;8. Commissariat à l’Energie Atomique (CEA), iRTSV- Biology of Cancer and infection, Grenoble, France;9. Zilkha Neurogenetic Institute, Keck School of Medicine of University of Southern California, USA;10. Department of Maternal-Fetal Medicine, Pregnancy Research Centre, The Royal Women''s Hospital, Victoria, Australia;11. Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia;12. Department of Obstetrics and Gynecology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands;13. Department of Obstetrics and Gynaecology, The University of Melbourne, Victoria, Australia |
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Abstract: | BackgroundDue to limitations in standard culture methods, the impact of pneumococcal conjugate vaccine (PCV) immunization on nasopharyngeal bacterial carriage density is unclear, including among HIV-infected children.MethodsThe prevalence and density of serotype/serogroup-specific pneumococcal and other nasopharyngeal colonizing bacteria were investigated in archived swabs of HIV-infected and HIV-uninfected, PCV-7 immunized (at 6, 10 and 14 weeks of age) South African children collected at 9 and 16 months of age. During the course of the study, PCV-immunization of children in Soweto was limited to study-participants, as the vaccine had not been introduced into the public immunization program.ResultsAt 9 months of age, the prevalence of overall pneumococcal colonization was lower in HIV-infected (58.6%) than HIV-uninfected children (69.9%, p = 0.02), mainly due to lower prevalence of non-vaccine-serotype colonization (27.8% vs. 40%, respectively; p = 0.047). The mean-log10 density of pneumococcal colonization was, however, higher in HIV-infected (4.81 CFU/ml) than HIV-uninfected pneumococcal colonized children (4.44 CFU/ml; p = 0.014); mainly due to higher mean-log10 density of PCV7-serotype colonization (4.21 vs. 3.72 CFU/ml; p = 0.014). No difference in the prevalence or density of overall pneumococci was found at 16 months of age. The prevalence of non-vaccine serotype colonization remained 1.7 fold higher in HIV-uninfected (60.4%) than HIV-infected children (50.9%, p = 0.049). Other differences included a lower prevalence of H. influenzae colonization in HIV-infected (42.3% and 56%) than HIV-uninfected children (64.2% and 73.4%) at both 9 and 16 months of age respectively; however, the density of colonization was similar.ConclusionIncreased carriage density of residual PCV7-serotypes might cause HIV-infected children to have a higher risk of pneumococcal disease. The higher carriage density observed in HIV-infected children could be attributed to a combination of factors, including HIV treatment and impaired host immunity. Additional studies are needed. |
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Keywords: | HIV-1 infection Pneumococcal Conjugate Vaccine Fluidigm |
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