Open Access Research article

Effectiveness of the polysaccharide pneumococcal vaccine among HIV-infected persons in Brazil: a case control study

Maria Amelia SM Veras1234*, Wayne TA Enanoria1, Euclides A Castilho2 and Arthur L Reingold1

Author Affiliations

1 Division of Epidemiology, School of Public Health, University of California, Berkeley, USA

2 Preventive Medicine Department, School of Medicine, University of São Paulo, Brazil

3 Social Medicine Department, School of Medical Sciences of Santa Casa of São Paulo, Brazil

4 Emilio Ribas Infectious Diseases Institute, São Paulo State Health Department, São Paulo, Brazil

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BMC Infectious Diseases 2007, 7:119  doi:10.1186/1471-2334-7-119

Published: 23 October 2007

Abstract

Background

Polysaccharide pneumococcal vaccine is recommended for use in HIV-infected adults in Brazil but there is uncertainty about its effectiveness in this patient population.

The main objective of this study was to assess the effectiveness of the 23-valent polysaccharide pneumococcal vaccine against invasive pneumococcal infection among HIV-infected adult patients in São Paulo, Brazil.

Methods

A case-control study of 79 cases and 242 controls matched on CD4+ cell count and health care setting was conducted. Among HIV-infected adults in São Paulo, Brazil, with and without

    S
.
    pneumoniae
recovered from a normally sterile site; prior receipt of 23 valent polysaccharide pneumococcal vaccine was determined by review of medical records and patient interview.

Results

After adjustment for confounding factors, the point estimate for the effectiveness of 23 valent polysaccharide vaccine among HIV-infected adults against all invasive pneumococcal infection was 18% (95% CI: <0 to 62%).

Conclusion

We were unable to demonstrate a statistically significant protective effect of 23 valent polysaccharide against invasive pneumococcal infection vaccine among HIV-infected adults in Brazil.

While the vaccine is relatively inexpensive and safe, its effectiveness among HIV-infected adults in Brazil is uncertain.