Because very few individuals (only three) had specific antibodies against serotype 6B at baseline and all study subjects except two did not have a twofold increase in the concentrations of specific antibodies against serotype 6B after vaccination, data for antibody responses against 6B were not analysed. The laboratory staff member who performed the determinations of antibody responses was blinded to the identity and clinical characteristics of the subjects, their vaccination status, and whether they

were receiving HAART. All statistical analyses were performed using sas statistical software (version 8.1; SAS Institute Inc., Cary, NC, USA). Categorical variables were compared using χ2 or Fisher’s exact test, whereas noncategorical variables were compared

using Wilcoxon’s rank-sum test. Univariate analysis followed by multivariate analysis was performed to identify factors associated with a twofold or greater find more increase in antibody responses to one of the three selected serotypes at follow-up for five consecutive years. All tests were two-tailed and a P-value <0.05 was considered significant. Serial blood specimens were collected from 169 HIV-infected patients before and after vaccination (at 6 months and 1, 2, 3, 4 and 5 years following vaccination). The demographic selleck inhibitor and clinical characteristics of the four groups of patients at vaccination are shown in Table 1. There were no significant differences regarding age, sex, Cytidine deaminase risk behaviour for HIV transmission or the proportion of patients who were receiving HAART at vaccination. All patients except for two were receiving HAART when 23-valent PPV was given. Compared with the patients with CD4 counts ≥100 cells/μL at vaccination (groups 2, 3 and 4; n=134), patients with CD4 counts <100 cells/μL (group 1; n=35) had a shorter duration of HAART before vaccination (median 4 months) and poorer virological suppression; only 48.6% of the

patients in group 1 achieved undetectable plasma HIV RNA load at vaccination compared with 66.7–81.8% in the other three groups. The median observation duration after vaccination for each group was ≥5 years (Table 1). Although the absolute CD4 cell counts remained significantly lower in group 1 at year 5 of follow-up, similar or greater increases in absolute CD4 cell counts after HAART were observed in group 1 compared with groups 2, 3 and 4 throughout the 5-year follow-up period, suggesting a good immunological recovery after receipt of HAART for a longer period of time (Table 1). Before vaccination, similar proportions of the patients in the four groups had levels of antibodies to serotypes 14 and 19F ≥0.35 μg/mL, which has been suggested as the threshold for protective immunity against pneumococcal infection [29] (Fig. 1a and b), while a lower proportion of patients in groups 1 and 3 had protective levels of antibody to serotype 23F than in the other two groups (Fig.