Observational studyAIDS (London, England)2015
Persisting high prevalence of pneumococcal carriage among HIV-infected adults receiving antiretroviral therapy in Malawi: a cohort study.
Observational study in AIDS (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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Who cites it
31 citing papers in PubMed, 48 citations in OpenAlex.
- Pneumococcal population structure influences the effects of air pollution on invasive disease risk in South Africa.Nature microbiology · 2026Article
- Persistent pneumococcal colonisation in antiretroviral-treated HIV infection is associated with nasal inflammation.Nature communications · 2025Article
- High Propensity for Multidrug-Resistant Pneumococcal Shedding Among Adults Living With HIV on Stable Antiretroviral Therapy in Malawi.Open forum infectious diseases · 2025Article
- Article
- Clinical and Microbial Determinants of Upper Respiratory Colonization With Streptococcus pneumoniae and Native Microbiota in People With Human Immunodeficiency Virus Type 1 and Control Adults.The Journal of infectious diseases · 2024Article
- Estimating pneumococcal carriage dynamics in adults living with HIV in a mature infant pneumococcal conjugate vaccine programme in Malawi, a modelling study.BMC medicine · 2024Article
- Experimental pneumococcal carriage in people living with HIV in Malawi: the first controlled human infection model in a key at-risk population.Wellcome open research · 2024Article
- Considerations in planning a controlled human infection model in at-risk groups in sub-Saharan Africa: the case for pneumococcal challenge in people living with HIV in Malawi and a report of stakeholder consultation.Wellcome open research · 2024Article
- The metabolic, virulence and antimicrobial resistance profiles of colonising Streptococcus pneumoniae shift after PCV13 introduction in urban Malawi.Nature communications · 2023Article
- Optimization of a high-throughput nanofluidic real-time PCR to detect and quantify of 15 bacterial species and 92 Streptococcus pneumoniae serotypes.Scientific reports · 2023Article
- Social mixing patterns relevant to infectious diseases spread by close contact in urban Blantyre, Malawi.Epidemics · 2022Article
- Intracellular survival ofFrontiers in immunology · 2022Article
- Estimating the contribution of HIV-infected adults to household pneumococcal transmission in South Africa, 2016-2018: A hidden Markov modelling study.PLoS computational biology · 2021Article
- The nose is the best niche for detection of experimental pneumococcal colonisation in adults of all ages, using nasal wash.Scientific reports · 2021Article
- Impact and effectiveness of 13-valent pneumococcal conjugate vaccine on population incidence of vaccine and non-vaccine serotype invasive pneumococcal disease in Blantyre, Malawi, 2006-18: prospective observational time-series and case-control studies.The Lancet. Global health · 2021Observational
- Human Immunodeficiency Virus Infection Is Associated With Increased Meningococcal Carriage Acquisition Among First-year Students in 2 South African Universities.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Tuberculosis case notifications in Malawi have strong seasonal and weather-related trends.Scientific reports · 2021Article
- Article
- Vaccine strategies to reduce the burden of pneumococcal disease in HIV-infected adults in Africa.Expert review of vaccines · 2020Review
- Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
Abstract
objectiveHIV-infected adults have high rates of pneumococcal carriage and invasive disease. We investigated the effect of antiretroviral therapy (ART) on pneumococcal carriage in HIV-infected adults prior to infant pneumococcal conjugate vaccine (PCV) rollout.
designObservational cohort study.
methodsWe recruited HIV-infected adults newly attending a rural HIV clinic in northern Malawi between 2008 and 2010. Nasopharyngeal samples were taken at baseline and after 6, 12, 18 and 24 months. We compared pneumococcal carriage by ART status using generalized estimated equation models adjusted for CD4 cell count, sex, seasonality, and other potential confounders.
resultsIn total, 336 individuals were included, of which 223 individuals started ART during follow-up. Individuals receiving ART had higher pneumococcal carriage than individuals not receiving ART (25.9 vs. 19.8%, P = 0.03) particularly for serotypes not included in PCV13 (16.1 vs. 9.6% P = 0.003). Following adjustment, increased carriage of non-PCV13 serotypes was still observed for individuals on ART, but results for all serotypes were nonsignificant [all serotypes: adjusted risk ratio (aRR) 1.22 (0.95-1.56); non-PCV13 serotypes: aRR 1.72, 95% CI 1.13-2.62].
conclusionPneumococcal carriage in HIV-infected adults in Malawi remained high despite use of ART, consistent with failure of mucosal immune reconstitution in the upper respiratory tract. There was evidence of increased carriage of non-PCV13 serotypes. HIV-infected adults on ART could remain an important reservoir for pneumococcal diversity post infant pneumococcal vaccine introduction. Control of pneumococcal disease in African HIV remains a priority.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.