Mechanisms of Impaired HIV-associated B Cell and Pneumococcal Vaccine Responses

Exclusion Criteria

• •For all subjects:
• •age \<18 or \>55 years
• •history of prior pneumococcal vaccination
• •immunosuppressive therapy, defined as: prednisone \>15mg/day currently or \>14 days in the past 3 months, cytotoxic agents, anti-metabolites, cyclosporine, anti-tumor necrosis factor, B cell monoclonal antibodies
• •current or chronic pulmonary infection (bacterial, fungal, mycobacterial), pneumonia, or rhinosinusitis within 2 months
• •chronic lung disease
• •renal insufficiency, defined as serum creatinine \>1.6
• •active liver disease, including hepatitis C virus infection
• •history of splenectomy
• •history of antibacterial therapy within 3 months of nasal swab (week 0)
• •current alcohol abuse
• •chronic heart disease
• •diabetes
• •current cigarette smoking