Jallow Sabelle, Madhi Shabir A
a Respiratory and Meningeal Pathogens Unit, Faculty of Health Sciences , University of Witwatersrand , Johannesburg , South Africa.
b Centre for Vaccines and Immunology , National Institute for Communicable Diseases of the National Health Laboratory Service , Johannesburg , South Africa.
Expert Rev Vaccines. 2017 May;16(5):453-465. doi: 10.1080/14760584.2017.1307740. Epub 2017 Apr 10.
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.
与未感染艾滋病毒的儿童相比，感染艾滋病毒儿童的侵袭性肺炎球菌疾病（IPD）发病率高出20至40倍，包括接受抗逆转录病毒治疗（ART）的感染艾滋病毒儿童。此外，与未接触艾滋病毒的儿童相比，接触艾滋病毒但未感染的儿童患IPD的风险高出2.7倍。涵盖领域：我们检索了PubMed数据库中以“PCV”和“HIV”为关键词的研究；仅涉及成人的研究被排除。专家评论：虽然抗逆转录病毒治疗（ART）和肺炎球菌结合疫苗（PCV）降低了感染艾滋病毒儿童的IPD发病率和死亡率，但未接受过ART治疗和免疫抑制的儿童对大多数PCV血清型的免疫原性较差；这突出表明需要将ART与PCV联合使用。此外，迫切需要开展研究以确定最佳的PCV给药方案、给药时间和剂量数量，以确保在感染艾滋病毒儿童中疫苗持续有效。
