EQUAL IGG ANTIBODY-RESPONSE TO PNEUMOCOCCAL VACCINATION IN ALL STAGES OF HUMAN-IMMUNODEFICIENCY-VIRUS DISEASE

To evaluate the immunogenicity and safety of a 23-valent pneumococcal vaccine in human immunodeficiency virus (HIV)-seropositive patients, 80 men and 18 women received 1 dose of the vaccine (Pneumo 23; Pasteur Merieux MSD, Brussels), The total IgG antibody response against all 23 Streptococcus pneumoniae capsular antigens was measured. Antibody levels were expressed in arbitrary units per microliter, referring to a standard curve. Geometric mean titers of the total IgG capsular antibodies on the day of vaccination and 30-45 days later were compared. The ratios of titers after and before vaccination in patients with >500, 200-500, and <200 CD4 lymphocytes/mu L were 10, 10, and 12.6, respectively, Nonresponse (ratio <4) occurred in 17% of patients and was unrelated to CD4 cell count. The vaccine was well tolerated; no serious side effects occurred. In 83% of the patients with MV infection, the total antipneumococcal IgG level was higher after vaccination.