Methods: HIV-infected adults seeking care at the Designated AIDS Center in Syracuse, NY between December 2013 and March 2015 were eligible. Following informed consent, an NP sample was collected, and patient demographics, medical and social history including risk factors for invasive pneumococcal disease (IPD) recorded. Pneumococci were identified from the samples using standard microbiologic techniques.
Results: 707 nasopharyngeal samples were collected from 414 HIV-infected adults; 301 (72%) were males. Mean and median ages were 46.3 and 48 years, respectively. 391 (94%) and 42 (10%) were taking anti-retroviral therapy and sulfamethoxazole/trimethoprim prophylaxis, respectively. In addition to HIV infection, 210 (51%) had another co-morbidity placing them at increased risk for IPD. 12 (3%) had received PCV-13 and 220 (53%) had received pneumococcal polysaccharide vaccine-23 as recommended. Pneumococcus was isolated from 28/710 (4%) of samples and from 24/414 (6%) of patients. Colonization status was not associated with gender, race, co-morbidities, antibiotic use, smoking, alcohol use, intravenous drug use, children in the household, vaccine status, absolute neutrophil count, CD4 count, or viral load, however, colonized adults were more likely to have respiratory symptoms than those who were not colonized (46% vs 27%, p=0.02).
Conclusion: Current pneumococcal colonization rates in HIV-infected adults are below historical rates suggesting reduction due to the widespread use of PCV-13. When present, colonization may be associated with respiratory symptoms.
D. Cibula, None
T. Endy, Sanofi Pasteur: Scientific Advisor , Consulting fee
Merck: Chair DSMB Dengue Vaccines , Consulting fee
Veristat: Chair DSMB Ebola Vaccines , Consulting fee
NIH Study Section: Training grants , NIH honorarium
J. B. Domachowske, GlaxoSmithKline: Investigator and Scientific Advisor , Consulting fee and Research support
Merck: Investigator and Scientific Advisor , Consulting fee and Research support
M. Suryadevara, Pfizer ASPIRE Award: Investigator , Research support