Pneumococcal Acquisition Among Infants Exposed to HIV in Rural Malawi: A Longitudinal Household Study.
Pneumococcal Acquisition Among Infants Exposed to HIV in Rural Malawi: A Longitudinal Household Study.
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DOI：
10.1093/aje/kwv134
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发表时间：
2016-01-01
影响因子：
5
通讯作者：
French N
中科院分区：
文献类型：
--
作者：
Heinsbroek E;Tafatatha T;Chisambo C;Phiri A;Mwiba O;Ngwira B;Crampin AC;Read JM;French N
感染人类免疫缺陷病毒 (HIV) 的成人中肺炎链球菌（肺炎球菌）的携带率高于未感染的成人。我们假设，接触艾滋病毒的婴儿比未接触艾滋病毒的婴儿更早、更频繁地成为鼻咽肺炎球菌携带者。我们比较了 2009 年至 2011 年引入肺炎球菌结合疫苗之前马拉维卡龙加区母亲艾滋病毒状况和家庭接触情况的婴儿肺炎球菌感染情况。在出生后第一年，每 4-6 周从已知感染 HIV 的婴儿、他们的母亲和其他家庭成员身上采集一次鼻咽拭子。我们通过母亲艾滋病毒状况、血清型特异性家庭暴露和其他风险因素（包括季节性）研究了婴儿肺炎球菌的感染情况。我们招募了 54 名接触过 HIV 的婴儿和 131 名未接触过 HIV 的婴儿。母亲 HIV 状况的肺炎球菌感染率没有显着差异（调整后比率 (aRR) = 1.00，95% 置信区间 (CI)：0.87、1.15）。母亲携带与更多地获得相同血清型有关（aRR = 3.09，95% CI：1.47，6.50），但调整后的人群归因分数可以忽略不计（1.9%，95% CI：0.0，4.3）。 5 岁以下儿童的血清型特异性暴露与较高的获得率相关（aRR = 4.30，95% CI：2.80，6.60；调整后的人群归因分数 = 8.8%，95% CI：4.0，13.4）。我们没有发现任何证据表明孕产妇艾滋病毒感染会影响肺炎球菌疫苗接种对该人群定植的影响。
The prevalence of Streptococcus pneumoniae (pneumococcus) carriage is higher in adults who are infected with human immunodeficiency virus (HIV) than in adults who are not. We hypothesized that infants exposed to HIV become carriers of nasopharyngeal pneumococcus earlier and more frequently than infants who are not exposed to HIV. We compared infant pneumococcal acquisition by maternal HIV status and household exposure in Karonga District, Malawi, in 2009–2011, before the introduction of pneumococcal conjugate vaccine. Nasopharyngeal swabs were collected every 4–6 weeks in the first year of life from infants with known HIV-exposure status, their mothers, and other household members. We studied infant pneumococcal acquisition by maternal HIV status, serotype-specific household exposure, and other risk factors, including seasonality. We recruited 54 infants who were exposed to HIV and 131 infants who were not. There was no significant difference in pneumococcal acquisition by maternal HIV status (adjusted rate ratio (aRR) = 1.00, 95% confidence interval (CI): 0.87, 1.15). Carriage by the mother was associated with greater acquisition of the same serotype (aRR = 3.09, 95% CI: 1.47, 6.50), but the adjusted population attributable fraction was negligible (1.9%, 95% CI: 0.0, 4.3). Serotype-specific exposure to children under 5 years of age was associated with higher acquisition (aRR = 4.30, 95% CI: 2.80, 6.60; adjusted population attributable fraction = 8.8%, 95% CI: 4.0, 13.4). We found no evidence to suggest that maternal HIV infection would affect the impact of pneumococcal vaccination on colonization in this population.