5 days—median, 312.0 days (259.0–458.0 days). The overall antibody response in HIV-infected patients receiving one or two doses of the meningococcal serogroup C conjugate vaccine was 81.4% (35 of the 43 patients evaluated). Of the 35 responders, 31 had received a single dose and 4 had received two doses. As shown in Table

1, after the first dose of the vaccine, side effects were observed in 16.3% of the HIV+ group patients and in 44% of the HIV− group patients (p = 0.004). The reported side effects are shown in Table 2. No side effects were reported among the 10 patients who received a second (booster) EPZ-6438 chemical structure dose of the vaccine. In the present study, 72.1% of the HIV-infected patients evaluated were responsive to a single dose of meningococcal serogroup C conjugate vaccine (as is usually recommended), and this rate increased to 81.4% when those receiving a second dose were included. However, 100% of the

non-HIV-infected patients achieved protective levels after receiving the first dose, a result that is consistent with those of other studies involving healthy children or adolescents [35], [36], [37] and [38]. The magnitude of the antibody response obtained was significantly smaller in the HIV-infected patients than in the non-HIV-infected patients. The differences found were expected, given the results of studies of the use of other vaccines in HIV-infected patients. In general, the response to vaccination was weaker in HIV-infected patients than in those not so infected. However, the response obtained in the present study was significant for the prevention of meningococcal disease in such a susceptible KU-57788 purchase population. It is of note that either two doses provided better results than did a single dose. These results are in accordance with a recent publication of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention and the American Academy of Pediatrics, which recommends an immunization

schedule with two doses of the quadrivalent conjugate vaccine (serogroups A, C, Y, and W135) for HIV-infected patients [39]. Nevertheless, in our study only 40% of the HIV-infected patients who were revaccinated responded to the booster dose, possibly due to immune system dysfunction caused by the HIV. It is debatable whether the interval between the two doses influenced the response in those patients. Further studies, with shorter intervals between doses, are needed in order to evaluate such aspect. We found that the antibody response in HIV-infected patients did not correlate with clinical variables or with the results of viral and immunological tests. Therefore, the responders and non-responders presented the same profile: CDC classification B and C; absolute CD4 count >350 cells/mm3 (with a proportion >25%); and viral loads below the detection limit in most cases. The HIV+ group showed very similar characteristics since the beginning, but no sample was calculated to determine the associations between those variables.