Hunan Provincial Center for Disease Control and Prevention, No.450 Section 1 Furongzhong middle Road, Kaifu District, Changsha, Hunan 410005, China.
University of South China, No. 28, Changsheng West Road, Hengyang City, Hunan 421001, China.
Vaccine. 2022 Jan 3;40(1):37-42. doi: 10.1016/j.vaccine.2021.11.058. Epub 2021 Nov 29.
Due to the lack of understanding of the protective effects and safety of 23-valent pneumococcal polysaccharide vaccine (PPV23) in immune-deficient populations, the vaccination rate of PPV23 among HIV-infected patients is still very low in China. The main objectives of this study were to determine whether the efforts to assess measures for the prevention of pneumococcal pneumonia are still worthwhile, and provide designated vaccination program of HIV-infected persons for government policy based on.
60 HIV-infected adults in Lanshan county who had never been vaccinated with any pneumococcal vaccine were enrolled in this study, voluntary vaccination of PPV23 and One-year follow-up after vaccination can be completed.
76.67% patients (46/60) had serologic response at 12 months after vaccine, CD4 count(≤500 cells/ul or > 500 cells/ul) and Month from diagnosis to first antiviral therapy (≤1 month or > 1 month) were related to antibody responses (p < 0.05).In this study, PPV23 was well tolerated, no adversereaction was reported.11 Streptococcus pneumoniae pneumonia (9.17%,11/120) occurred in the Unvaccinated group and 1 case(1.67%,1/60)in the vaccination group within one year after vaccination(Fisher's exact probability, P = 0.225). The VE was 81.79%. The per capita benefit was 39.32 dollars, thebenefit-costratio = 1.19. There are significant statistical differences between the vaccinated group and the non-vaccinated group in outpatient costs (p < 0.05, 95 %CI: 9.29-32.11), Medicine costs (p = 0.017, 95 %CI: 2.47-24.44), and disease related indirect costs (p = 0.038, 95 %CI: 0.93-33.63) within one year of vaccination.
Our study results showed that PPV23 can be safely and effectively administered to HIV-1 infected individuals and effectively preventing Streptococcal pneumonia. Considering the cost-benefit of vaccination among HIV-infected persons, as it has been reported in our study, it is necessary to promote the widespread use of the vaccine among HIV-infected persons in the future.
由于对 23 价肺炎球菌多糖疫苗（PPV23）在免疫缺陷人群中的保护作用和安全性认识不足，中国 HIV 感染者接种 PPV23 的比例仍然很低。本研究的主要目的是确定评估预防肺炎球菌性肺炎措施的工作是否仍然有价值，并为政府提供针对 HIV 感染者的指定疫苗接种计划。
本研究纳入了兰山区 60 名从未接种过任何肺炎球菌疫苗的 HIV 感染者，他们自愿接种 PPV23，并在接种后进行为期 1 年的随访。
76.67%（46/60）的患者在疫苗接种后 12 个月时产生了血清学应答，CD4 计数（≤500 个/ul 或>500 个/ul）和从诊断到首次抗病毒治疗的时间（≤1 个月或>1 个月）与抗体应答相关（p<0.05）。在本研究中，PPV23 具有良好的耐受性，未报告不良反应。在接种后 1 年内，未接种组发生 11 例（9.17%，11/120）肺炎链球菌肺炎，接种组发生 1 例（1.67%，1/60）（Fisher 确切概率，P=0.225）。疫苗的保护率为 81.79%。人均效益为 39.32 美元，效益成本比=1.19。接种组和未接种组在门诊费用（p<0.05，95%CI：9.29-32.11）、药物费用（p=0.017，95%CI：2.47-24.44）和疾病相关间接费用（p=0.038，95%CI：0.93-33.63）方面有统计学差异。
我们的研究结果表明，PPV23 可安全有效地用于 HIV-1 感染者，并能有效预防肺炎链球菌肺炎。考虑到 HIV 感染者接种疫苗的成本效益，正如本研究报告的那样，有必要在未来促进 HIV 感染者广泛使用疫苗。
