A Trial of a 7-Valent Pneumococcal Conjugate Vaccine in HIV-Infected Adults

Pneumococcal infection is an important cause of death and complications in adults with human immunodeficiency virus (HIV) infection, particularly in Africa. In this placebo-controlled, randomized trial involving 496 predominantly HIV-infected Malawian adults who had recently had an invasive pneumococcal infection, the 7-valent conjugated pneumococcal vaccine was found to have 74% efficacy in preventing subsequent invasive pneumococcal infection with a vaccine-associated serotype. In predominantly HIV-infected Malawian adults who had recently had an invasive pneumococcal infection, the 7-valent conjugated pneumococcal vaccine was found to have 74% efficacy in preventing subsequent invasive pneumococcal infection. Streptococcus pneumoniae is a leading cause of death and complications in adults with human immunodeficiency virus (HIV) infection, particularly in sub-Saharan Africa. 1 , 2 The risk of invasive pneumococcal disease is 30 to 100 times as high in patients with HIV infection as in age-matched controls without such infection. 3 , 4 Recurrent invasive pneumococcal disease is common, with up to 25% of patients having an additional episode, predominantly reinfection, in the subsequent 12 months. 1 , 5 Even among patients who have access to timely and effective care, the case fatality rate with invasive pneumococcal disease is at least 8% 6 and rises to 50% . . .