10779/rcsi.10776353.v1 C Sadlier C Sadlier S O'Dea S O'Dea Kathleen Bennett Kathleen Bennett J Dunne J Dunne N Conlon N Conlon C Bergin C Bergin Immunological efficacy of pneumococcal vaccine strategies in HIV-infected adults: a randomized clinical trial Royal College of Surgeons in Ireland 2019 Vaccine HIV Clinical Trial Epidemiology 2019-11-22 15:52:26 Journal contribution https://repository.rcsi.com/articles/journal_contribution/Immunological_efficacy_of_pneumococcal_vaccine_strategies_in_HIV-infected_adults_a_randomized_clinical_trial/10776353 <p>The aim of this study was to compare the immunologic response to a prime-boost immunization strategy combining the 13-valent conjugate pneumococcal vaccine (PCV13) with the 23-valent polysaccharide pneumococcal vaccine (PPSV23) versus the PPSV23 alone in HIV-infected adults. HIV-infected adults were randomized to receive PCV13 at week 0 followed by PPSV23 at week 4 (n=31, prime-boost group) or PPSV23 alone at week 4 (n=33, PPSV23-alone group). Serotype specific IgG geometric mean concentration (GMC) and functional oposonophagocytic (OPA) geometric mean titer (GMT) were compared for 12 pneumococcal serotypes shared by both vaccines at week 8 and week 28. The prime-boost vaccine group were more likely to achieve a ≥2-fold increase in IgG GMC and a GMC >1ug/ml at week 8 (odds ratio (OR) 2.00, 95% confidence interval (CI) 1.46–2.74, p<0.01) and week 28 (OR 1.95, 95% CI 1.40–2.70, p<0.01). Similarly, the prime-boost vaccine group were more likely to achieve a ≥4-fold increase in GMT at week 8 (OR 1.71, 95% CI 1.22–2.39, p<0.01) and week 28 (OR 1.6, 95% CI 1.15–2.3, p<0.01). This study adds to evidence supporting current pneumococcal vaccination recommendations combining the conjugate and polysaccharide pneumococcal vaccines in the United States and Europe for HIV-infected individuals.</p>