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

Sabelle Jallow1,2, Shabir A Madhi1,2

  • 1a Respiratory and Meningeal Pathogens Unit, Faculty of Health Sciences , University of Witwatersrand , Johannesburg , South Africa.

Expert Review of Vaccines
|March 30, 2017
PubMed

Insights

Children with HIV face a significantly higher risk of invasive pneumococcal disease (IPD). Combined antiretroviral therapy (ART) and pneumococcal conjugate vaccines (PCV) are crucial for protection, but further research on optimal PCV schedules is needed.

Area of Science:

  • Pediatric Infectious Diseases
  • Immunology
  • Public Health

Background:

  • HIV-infected children have a 20-40 fold higher incidence of invasive pneumococcal disease (IPD) compared to HIV-uninfected children.
  • Even HIV-exposed, uninfected children face a 2.7-fold increased risk of IPD.
  • Antiretroviral therapy (ART) and pneumococcal conjugate vaccines (PCV) have improved outcomes but do not eliminate risk entirely.

Purpose of the Study:

  • To review the current literature on PCV use in HIV-infected children.
  • To highlight the ongoing challenges and future research needs in preventing IPD in this vulnerable population.

Main Methods:

  • Literature search of the Pubmed database using terms 'PCV' and 'HIV'.
  • Inclusion of studies involving children; exclusion of studies involving only adults.

Main Results:

  • ART and PCV reduce IPD morbidity and mortality in HIV-infected children.
  • ART-naïve and immunosuppressed children exhibit inferior immunogenicity to most PCV serotypes.
  • Concomitant use of ART with PCV is essential.

Conclusions:

  • Optimal PCV dosing schedules, timing, and number of doses require urgent investigation.
  • Sustained vaccine efficacy in HIV-infected children necessitates further research into vaccination strategies.
Abstract

Keywords:
HIV-exposed uninfected childrenHIV-infected childrenStreptococcus pneumoniaeinvasive pneumococcal diseasepneumococcal conjugate vaccinepneumoniareview

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