Invasive Streptococcus pneumoniae Infections Declining in HAART Era

R.T. Heffernan and colleagues at the New York City Department of Health & Mental Hygiene conducted the current study to describe trends in invasive pneumococcal disease incidence among AIDS patients since the introduction of highly active antiretroviral therapy (HAART). "We used time-trend analysis of annual invasive pneumococcal disease incidence rates from a population-based, active surveillance system," the investigators wrote.

The researchers calculated annual incidence rates for five July-June periods using data from San Francisco County, the six-county Baltimore metropolitan area, and Connecticut. "The numerators were the numbers of invasive Streptococcus pneumoniae infections among persons 18-64 years of age with AIDS; the denominators were the number of persons living with AIDS, estimated on the basis of AIDS surveillance data," the report stated.

The researchers found that annual incidence of invasive pneumococcal disease declined from 1,094 cases/100,000 persons with AIDS (July 1995-June 1996) to 467 cases/100,000 AIDS patients (July 1999-June 2000). "The annual percentage changes in incidence were -34, -29, -8 and -1 percent," the authors wrote.

"Declines were similar by surveillance area, sex, and race/ethnicity," the report stated. "During the final year of the study, the invasive pneumococcal disease incidence in persons with AIDS was half that of the pre-HAART era but was still 35 times higher than that in similarly aged non-HIV-infected adults."

"In the United States, invasive pneumococcal disease incidence declined sharply across a range of subgroups living with AIDS during the period after the widespread introduction of HAART," the authors concluded. "Despite these gains, persons with AIDS remain at high risk for invasive pneumococcal disease."

The study, "Declining Incidence of Invasive Streptococcus pneumoniae Infections Among Persons with AIDS in an Era of Highly Active Antiretroviral Therapy, 1995-2000," appeared in the Journal of Infectious Diseases (2005;191(12):2038-2045).

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