The effect of chronic cytomegalovirus infection on pneumococcal vaccine responses.

O'Connor D., Trück J., Lazarus R., Clutterbuck EA., Voysey M., Jeffery K., Pollard AJ.

BACKGROUND: Immune function declines with age and has been associated with reduced vaccine responsiveness. Chronic infection with cytomegalovirus (CMV) has been proposed as a contributor to poorer responses in older adults. A pneumococcal vaccine has been recommended in the United Kingdom for those aged >65 years since 2003 to prevent pneumococcal disease. METHODS: We evaluated the effect of age and CMV status on pneumococcal vaccine responses in 348 individuals aged 50-70 years. RESULTS: We found participant age to be associated with serotype-specific and functional antibody titers after pneumococcal vaccination, with a mean 6.2% (95% confidence interval, 2.9%-9.5%) reduction in postvaccination functional antibody titers per year. CMV status was not associated with serotype-specific immunoglobulin G concentrations or functional antibody titers after pneumococcal vaccination. However, CMV seropositivity was associated with higher levels of prevaccination functional antibody for 4 of 7 pneumococcal serotypes assessed. CONCLUSIONS: These data imply that CMV infection is not directly responsible for the decline in pneumococcal vaccine responses seen with age but suggest that CMV-seropositive individuals differ in their natural exposure to pneumococci or have altered mucosal immune responses after colonization with this organism.

DOI

10.1093/infdis/jit673

Type

Journal article

Journal

J Infect Dis

Publication Date

15/05/2014

Volume

209

Pages

1635 - 1641

Keywords

Aged, Antibodies, Bacterial, Chronic Disease, Cytomegalovirus Infections, Female, Humans, Immunoglobulin G, Male, Middle Aged, Pneumococcal Vaccines

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