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Clinical and Diagnostic Laboratory Immunology, January 2004, p. 137-141, Vol. 11, No. 1
1071-412X/04/$08.00+0     DOI: 10.1128/CDLI.11.1.137-141.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Specificity of the Antibody Response to the Pneumococcal Polysaccharide and Conjugate Vaccines in Human Immunodeficiency Virus-Infected Adults

Daniel R. Feikin,^1* Cheryl M. Elie,¹ Matthew B. Goetz,² Jeffrey L. Lennox,³ George M. Carlone,¹ Sandra Romero-Steiner,¹ Patricia F. Holder,¹ William A. O'Brien,⁴ Cynthia G. Whitney,¹ Jay C. Butler,^1, and Robert F. Breiman^1,

Respiratory Diseases Branch, Division of Bacterial and Mycotic Diseases, National Centers for Infectious Diseases, Centers for Disease Control and Prevention,¹ Emory University and Grady Infectious Disease Program, Atlanta, Georgia,³ VA Greater Los Angeles Healthcare System and University of California Los Angeles, Los Angeles, California ,² University of Texas Medical Branch, Galveston, Texas⁴

Received 13 March 2003/ Accepted 16 September 2003

Nonspecific antibodies, which are thought to be nonprotective, have been shown to contribute a substantial proportion of the measured concentration in the standardized immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) for pneumococcal polysaccharide capsular antibodies. The presence of such antibodies in human immunodeficiency virus (HIV)-infected persons has not been evaluated. The amount of nonspecific antibodies is proportional to the reduction in IgG antibody concentration that occurs with serum absorption with the heterologous polysaccharide 22F. We measured the amount of nonspecific antibodies before and after vaccination with the pneumococcal conjugate vaccine (PCV; n = 33) or the pneumococcal polysaccharide vaccine (PPV; n = 34) in HIV-infected adults with CD4 counts of 200 cells/mm³. Blood was drawn before and 2 months after vaccination. For prevaccination sera, we found a substantial amount of nonspecific antibodies for serotypes 4, 6B, 9V, and 23F (23 to 47% of measured IgG concentration), but not for serotype 14. There tended to be proportionately less nonspecific antibodies in postvaccine sera than prevaccine sera for PCV, but not for PPV. Subjects with a low HIV viral load (400 copies/ml) had proportionately more nonspecific antibodies than those with higher viral load before and after both vaccines. After 22F absorption, the geometric mean concentrations of antibodies were significantly higher post-PCV than post-PPV for the high viral load group for all five serotypes, but for no serotypes in the low viral load group. These findings confirm that absorption with a heterologous pneumococcal polysaccharide (e.g., 22F) is necessary to remove nonspecific antibodies in a standardized IgG ELISA for pneumococcal capsular antibodies in HIV-infected adults.

Present address: CDC Arctic Investigations Program, Anchorage, AK 99508.

Present address: National Center for Infectious Diseases, CDC, and Centre for Health and Population Research, ICDDR-B, Dhaka 1000, Bangladesh.

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