Evolution of median HIV-RNA load and CD4∶CD8 ratios in recently infected patients.

<p>HIV-RNA load (A) and CD4∶CD8 ratios (B) in patients with high HIV-RNA as compared to the other patients. Median and interquartile range are shown. HIV-RNA viral load groups are defined as described in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0031859#s2" target="_blank">methods</a>. P-values are from Wilcoxon rank sum test between groups as follows: *p = 0.0001, **p = 0.038, *** p = 0.002. P-values from Wilcoxon Signed Rank between visits did not show significant differences. Numbers denote the n for each group at each time point.</p

Baseline virological and immunological parameters among individuals diagnosed with recent HIV infections by the BED-CEIA assay.

<p>Results are presented according to CD4 counts.</p><p>*CD4 counts available for 52/57 patients.</p

HIV serological characteristics of the study population (N = 492).

<p>RT: rapid testing. BED-CEIA: BED capture enzyme immunoassay. VL: Viral Load.</p><p>HIV positive and indeterminate serology by RT and BED-CEIA recent infection as defined in methods.</p

Self-reported clinical symptoms according to status of HIV infection.

<p>*Recent HIV infection defined by BED-CEIA, CD4 counts >200 cell/µl and VL>400 copies/mL.</p

Number of IPD cases caused by most common vaccine types among children <5 years of age admitted at Manhica District Hospital, 2003–2012.

<p>Number of IPD cases caused by most common vaccine types among children <5 years of age admitted at Manhica District Hospital, 2003–2012.</p

Prevalence of pneumococcal carriage by HIV infection, HIV exposure, and site.

<p>Prevalence of pneumococcal carriage by HIV infection, HIV exposure, and site.</p

Annual incidence rates of IPD cases among children <5 years of age admitted at Manhiça District Hospital, in Mozambique between 2001–2012.

<p>Annual incidence rates of IPD cases among children <5 years of age admitted at Manhiça District Hospital, in Mozambique between 2001–2012.</p

Factors associated with pneumococcal colonization among HIV-infected and–uninfected children aged <5 years in Mozambique.

<p>Factors associated with pneumococcal colonization among HIV-infected and–uninfected children aged <5 years in Mozambique.</p

Antibmicrobial susceptibility for 195 invasive pneumococcal isolates with antimicrobila susecptability performed from children <5 years old, hospitalized at Manhiça District Hospital, Mozambique.

<p>Antibmicrobial susceptibility for 195 invasive pneumococcal isolates with antimicrobila susecptability performed from children <5 years old, hospitalized at Manhiça District Hospital, Mozambique.</p

Nasopharyngeal carriage of <i>Streptococcus pneumoniae</i> among HIV-infected and –uninfected children <5 years of age before introduction of pneumococcal conjugate vaccine in Mozambique

<div><p>Nasopharyngeal carriage is a precursor for pneumococcal disease and can be useful for evaluating pneumococcal conjugate vaccine (PCV) impact. We studied pre-PCV pneumococcal carriage among HIV-infected and -uninfected children in Mozambique. Between October 2012 and March 2013, we enrolled HIV-infected children age <5 years presenting for routine care at seven HIV clinics in 3 sites, including Maputo (urban-south), Nampula (urban-north), and Manhiça (rural-south). We also enrolled a random sample of HIV-uninfected children <5 years old from a demographic surveillance site in Manhiça. A single nasopharyngeal swab was obtained and cultured following enrichment in Todd Hewitt broth with yeast extract and rabbit serum. Pneumococcal isolates were serotyped by Quellung reaction and multiplex polymerase chain reaction. Factors associated with pneumococcal carriage were examined using logistic regression. Overall pneumococcal carriage prevalence was 80.5% (585/727), with similar prevalences among HIV-infected (81.5%, 339/416) and HIV-uninfected (79.1%, 246/311) children, and across age strata. Among HIV-infected, after adjusting for recent antibiotic use and hospitalization, there was no significant association between study site and colonization: Maputo (74.8%, 92/123), Nampula (83.7%, 82/98), Manhiça (84.6%, 165/195). Among HIV-uninfected, report of having been born to an HIV-infected mother was not associated with colonization. Among 601 pneumococcal isolates from 585 children, serotypes 19F (13.5%), 23F (13.1%), 6A (9.2%), 6B (6.2%) and 19A (5.2%) were most common. The proportion of serotypes included in the 10- and 13-valent vaccines was 44.9% and 61.7%, respectively, with no significant differences by HIV status or age group. Overall 36.9% (n = 268) of children were colonized with a PCV10 serotype and 49.7% (n = 361) with a PCV13 serotype. Pneumococcal carriage was common, with little variation by geographic region, age, or HIV status. PCV10 was introduced in April 2013; ongoing carriage studies will examine the benefits of PCV10 among HIV-infected and–uninfected children.</p></div