OBJECTIVE:Invasive pneumococcal disease is a major cause of death in HIV-infected children. The objective of the study was to assess the quantitative antibody response to the seven pneumococcal serotypes of heptavalent pneumococcal conjugate vaccine in a group of HIV-infected children. METHODS:Study comprising 40 HIV-infected children aged between 2 and 9 years followed up in a specialized outpatient clinic in São Paulo, Brazil, between 2002 and 2003. Enzyme immunoassay (ELISA) was used to measure IgG antibody titers against pneumococcus capsule. Antibodies were measured immediately before and 1 month after the second dose of the vaccine. Two response criteria were used: IgG titers ≥1.3 μg/mL in the postimmunization serology and an increase of at least 4-fold in post-compared to pre-immunization serology. RESULTS:For the first criterion (≥1.3 μg/mL), 26 (65%) children had serological response to the vaccine, 12 (30%) showed post-immunization IgG titers of at least 1.3 μg/mL for all seven serotypes studied. For the second criterion studied (≥4-fold increase in post-compared to pre-immunization titers for four serotypes or more), serological response was seen in 15 (37.5%) children. CONCLUSIONS:Overall response to the heptavalent pneumococcal conjugate vaccine was adequate, showing a statistically signifi cant increase in the postimmunization geometric mean titers for the seven serotypes studied.

OBJECTIVE:Invasive pneumococcal disease is a major cause of death in HIV-infected children. The objective of the study was to assess the quantitative antibody response to the seven pneumococcal serotypes of heptavalent pneumococcal conjugate vaccine in a group of HIV-infected children. METHODS:Study comprising 40 HIV-infected children aged between 2 and 9 years followed up in a specialized outpatient clinic in São Paulo, Brazil, between 2002 and 2003. Enzyme immunoassay (ELISA) was used to measure IgG antibody titers against pneumococcus capsule. Antibodies were measured immediately before and 1 month after the second dose of the vaccine. Two response criteria were used: IgG titers ≥1.3 μg/mL in the postimmunization serology and an increase of at least 4-fold in post-compared to pre-immunization serology. RESULTS:For the first criterion (≥1.3 μg/mL), 26 (65%) children had serological response to the vaccine, 12 (30%) showed post-immunization IgG titers of at least 1.3 μg/mL for all seven serotypes studied. For the second criterion studied (≥4-fold increase in post-compared to pre-immunization titers for four serotypes or more), serological response was seen in 15 (37.5%) children. CONCLUSIONS:Overall response to the heptavalent pneumococcal conjugate vaccine was adequate, showing a statistically signifi cant increase in the postimmunization geometric mean titers for the seven serotypes studied.