Pneumococcal conjugate vaccine in HIV-infected and HIV-exposed, uninfected children

ABSTRACT

Introduction: Incidence of invasive pneumococcal disease (IPD) among HIV-infected children is 20–40 fold greater compared to HIV-uninfected children, including among HIV-infected children on antiretroviral therapy (ART). Also, HIV-exposed, uninfected children have 2.7-fold greater risk of IPD compared to HIV-unexposed children.

Areas covered: We reviewed studies identified on Pubmed database with the terms ‘PCV’ and ‘HIV’; studies involving adults only were excluded.

Expert commentary: While ART and pneumococcal conjugate vaccines (PCV) have reduced IPD morbidity and mortality in HIV-infected children, ART-naïve and immunosuppressed children have inferior immunogenicity to most PCV serotypes; highlighting the need for concomitant use of ART with PCV. Furthermore, studies to determine optimal PCV dosing schedules, timing and number of doses, are urgently required to ensure sustained vaccine efficacy in HIV-infected children.

KEYWORDS:

• Streptococcus pneumoniae
• pneumococcal conjugate vaccine
• HIV-infected children
• HIV-exposed uninfected children
• invasive pneumococcal disease
• pneumonia
• review

Declaration of interest

S A Madhi receives research grant support from GlaxoSmithKline and Pfizer, has served on speaker’s bureau and received honoraria for GlaxoSmithKline and Pfizer, and has received consultancy fees from GlaxoSmithKline, Pfizer, Novartis and Merck. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

This paper was not funded.