Impact of prior pneumococcal vaccination on clinical outcomes in HIV-infected adult patients hospitalized with invasive pneumococcal disease
Article first published online: 11 MAR 2009
© 2009 British HIV Association
Volume 10, Issue 6, pages 356–363, July 2009
How to Cite
Imaz, A., Falcó, V., Peñaranda, M., Jordano, Q., Martínez, X., Nadal, C., Curran, A., Planes, A., Dalmau, D., Ribera, E., Riera, M., Ruiz de Gopegui, E. and Pahissa, A. (2009), Impact of prior pneumococcal vaccination on clinical outcomes in HIV-infected adult patients hospitalized with invasive pneumococcal disease. HIV Medicine, 10: 356–363. doi: 10.1111/j.1468-1293.2009.00695.x
- Issue published online: 10 JUN 2009
- Article first published online: 11 MAR 2009
- Accepted 15 January 2009
- HIV infection;
- invasive pneumococcal disease;
- pneumococcal pneumonia;
- pneumococcal vaccine;
- 23-valent polysaccharide vaccine
Recent studies in hospitalized patients with community-acquired pneumonia have found a lower risk of bacteraemia and better clinical outcomes in patients who had previously received the 23-valent pneumococcal polysaccharide vaccine (PPV) in comparison with unvaccinated individuals. The aim of this study was to assess the influence of prior PPV on clinical outcomes in HIV-infected adult patients hospitalized with invasive pneumococcal disease (IPD).
This was an observational study of all consecutive HIV-infected adults hospitalized with IPD from January 1996 to October 2007 in three hospitals in Spain. Baseline characteristics and clinical outcome-related variables were compared according to prior PPV vaccination status.
A total of 162 episodes of IPD were studied. In 23 of these (14.2%), patients had previously received PPV. In both vaccinated and unvaccinated patients, most of the causal serotypes were included in the 23-valent PPV (76.9% and 84.1%, respectively). Overall, 25 patients (15.4%) died during hospitalization, 21 patients (13%) required admission to an intensive care unit (ICU) and 34 patients (21%) reached the composite outcome of death and/or admission to the ICU. None of the 23 patients who had previously received PPV died or required ICU admission, in comparison with 25 (18%; P=0.026) and 21 (15.1%; P=0.046), respectively, of the unvaccinated patients. The length of hospital stay for vaccinated patients was significantly shorter (8.48 vs. 13.27 days; P=0.011).
Although 23-valent PPV failed to prevent IPD in some HIV-infected patients, vaccination produced beneficial effects on clinical outcomes by decreasing illness severity and mortality related to IPD.