背景:尚未研究在HIV感染的成年人中对13价肺炎球菌结合疫苗(PCV13)与23价多糖疫苗(PPV23)的长期比较免疫应答。
方法:在这项前瞻性试点研究中,我们在间隔8周接种2剂PCV13(第1组)或1剂PPV23(第2组)后5年对两种疫苗共有的12种肺炎球菌血清型的HIV阳性成人血清型特异性IgG浓度进行了定量,并将其与疫苗接种前(BL)和1年(T1)后评估的浓度进行了比较.免疫原性的比较是基于几何平均浓度(GMC),相对于≥2个血清型的特异性抗体浓度从BL增加≥两倍的个体比例,以及血清型特异性IgG≥0.35μg/ml的个体百分比,≥1μg/ml和≥个体血清型特异性保护相关。
结果:我们纳入了91名受试者(中位CD4+650细胞/μl,>90%的HIV-RNA<50拷贝/ml);第1组(n=42)和第2组(n=49)的患者的主要特征均相同。对于血清型19F,PCV13组的GMC显着高于PPV23组(p=0.003)。与BL相比,两种疫苗对大多数血清型均显示出更高的GMC,即,第一组八人vs.第二组七人。关于T1,PCV13组的GMC显着降低了8个。PPV23组中有10种血清型。与PPV23组相比,PCV13组中更多的参与者从BL抗体水平增加≥2个血清型(78.6%vs.59.2%,p=0.042)。总的来说,血清型特异性IgG≥0.35μg/ml的受试者百分比,≥1μg/ml和≥个体血清型特异性保护相关性在组间相似。
结论:在这项研究中,HIV阳性成人具有良好的病毒免疫特征,两种疫苗均显示获得长期持久的血清学应答.我们发现两种疫苗之间的免疫原性差异很小,免疫后5年,PCV13优于PPV23。
背景:ClinicalTrials.gov标识符,NCT02123433。
BACKGROUND: Long-term comparative immunologic response to 13-valent pneumococcal conjugate vaccine (PCV13) versus 23-valent polysaccharide vaccine (
PPV23) among HIV-infected adults has not yet been investigated.
METHODS: In this prospective pilot study, we quantified in HIV-positive adults serotype-specific IgG concentrations of the 12 pneumococcal serotypes shared by both vaccines 5 years after vaccination with two doses of PCV13 8 weeks apart (group 1) or one dose of
PPV23 (group 2) and compared them with those assessed prior to vaccination (BL) and after 1 year (T1). Comparison of immunogenicity was based on geometric mean concentration (GMC), proportion of individuals with ≥ twofold increase from BL in specific antibody concentration against ≥ 2 serotypes and percentage of individuals with serotype-specific IgG ≥ 0.35 μg/ml, ≥ 1 μg/ml and ≥ individual serotype-specific correlates of protection.
RESULTS: We included 91 subjects (median CD4+ 650 cells/µl, > 90% with HIV-RNA < 50 copies/ml); patients in groups 1 (n = 42) and 2 (n = 49) were homogeneous for the main characteristics. GMCs were significantly higher in the PCV13 group than in the
PPV23 group for serotype 19F (p = 0.003). Both vaccines revealed higher significant GMCs to most serotypes compared with BL, i.e., eight in group 1 vs. seven in group 2. With respect to T1, GMCs decreased significantly in the PCV13 group for eight vs. ten serotypes in the
PPV23 group. More participants in the PCV13 group had ≥ 2 increase from BL in antibody levels to ≥ 2 serotypes compared with the PPV23 group (78.6% vs. 59.2%, p = 0.042). Overall, the percentage of subjects with serotype-specific IgG ≥ 0.35 μg/ml, ≥ 1 μg/ml and ≥ individual serotype-specific correlates of protection was similar between groups.
CONCLUSIONS: In this study with HIV-positive adults with a favorable viro-immunologic profile, both vaccines were shown to achieve a long-term durable serologic response. We found minor differences in immunogenicity between the two vaccines, which favored PCV13 over
PPV23 5 years after immunization.
BACKGROUND: ClinicalTrials.gov identifier, NCT02123433.