We have examined factors associated with pneumococcal vaccine uptake and interventions employed to improve vaccine uptake in our active HIV-infected cohort in St James’s Hospital (cohort of 2000 patients). (C Sadlier et al. “Improved vaccine coverage and outcomes in HIV-positive patients following introduction of an integrated vaccine programme” National Patient Safety Conference, 24th May 2013.) Most recently we have undertaken a randomised controlled trial comparing two pneumococcal vaccine strategies. This research examined “Immunological efficacy of a Prime-Boost immunisation Strategy Combining a 13-Valent Pneumococcal Conjugate Vaccine (PCV13) Followed by a 23-Valent Pneumococcal Polysaccharide Vaccine (PPV23) Versus PPV Alone in HIV-Infected Adults.” The primary objective of this study was to evaluate whether a strategy combining a prime with the 13-valent conjugate pneumococcal vaccine (PCV13) followed by a boost with the polysaccharide pneumococcal vaccine (PPV23) would improve immunogenicity against Streptococcus Pneumoniae Polysaccharides in HIV-infected patients.
Secondary objectives of this study were to determine the association if any between HIV RNA, CD4+T cell count, highly active antiretroviral therapy (HAART) and immunological response to above pneumococcal vaccination strategies.
Preliminary results have identified that immunogenicity and durability of pneumococcal vaccine response were enhanced by a prime boost vaccine strategy. This work adds to evidence supporting recent changes in US pneumococcal vaccination recommendations and strengthens the call to review current pneumococcal vaccine guidelines in Europe. (C Sadlier, N Conlon et al. Immunological efficacy of a Prime-Boost Strategy Combining a 13-Valent Pneumococcal Conjugate Vaccine (PCV13) Followed by a 23-Valent Pneumococcal Polysaccharide Vaccine (PPV23) Versus PPV Alone in HIV-Infected Adults. (Eudra CT number 2011-000260-99.) Oral Presentation ID
week, San Francisco 2013, BHIVA/BAASH annual conference, Liverpool 2014.) Building on this work we are collaboration with Dr Dufesna Slattery paediatrician Temple St Childrens Hospital to examine immunological response to pneumococcal vaccine in children with Cystic Additionally I have led and published a study on prevalence of Human papillomavirus in HIV-positive and HIVnegative MSM. I have established a research consortium (HPV MAPS) of national and international experts to interrogate further the utility of the HPV vaccine in this patient group. The proposed Cochrane review would represent a progression to pneumococcal related research in HIV infected adults for our group in St James’s Hospital. We are well placed to undertake this review which would represent a significant contribution to medical literature in the area of pneumococcal vaccination in HIV infected adults.
