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Volume 21, Number 4—April 2015

Increased Risk for Group B Streptococcus Sepsis in Young Infants Exposed to HIV, Soweto, South Africa, 2004–20081

Clare L. CutlandComments to Author , Stephanie J. Schrag, Michael C. Thigpen, Sithembiso C. Velaphi, Jeannette Wadula, Peter V. Adrian, Locadiah Kuwanda, Michelle J. Groome, Eckhart Buchmann, and Shabir A. Madhi
Author affiliations: University of the Witwatersrand, Johannesburg, South Africa (C.L. Cutland, S.C. Velaphi, J. Wadula, P.V. Adrian, L. Kuwanda, M.J. Groome, E. Buchmann, S.A. Madhi); Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Johannesburg (C.L. Cutland, P.V. Adrian, L. Kuwanda, M.J. Groome, S.A. Madhi); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.J. Schrag, M.C. Thigpen); Chris Hani Baragwanath Academic Hospital, Johannesburg (S.C. Velaphi, J. Wadula, E. Buchmann); National Institute for Communicable Diseases, Sandringham, South Africa (S.A. Madhi)

Main Article

Table 2

Estimated annual number of invasive GBS disease cases and associated deaths and potential annual vaccine-preventable fraction, South Africa*

Vaccine-preventable cases and deaths
Trivalent GBS-CV‡‡
Cases 2,105§§ 1.80 (1.73–1.88) 1,230¶¶ 1.49 (1.14–1.58) 886## 2.57 (2.40–2.75)
Deaths 278§§ 0.24 (0.21–0.27) 163¶¶ 0.20 (0.17–2.31) 117## 0.34 (0.28–0.41)
Pentavalent GBS-CV***
Cases 2,317§§ 1.99 (1.90–2.07) 1,354¶¶ 1.64 (1.56–1.73) 976## 2.83 (2.66–3.01)
Deaths 306§§ 0.26 (0.23–0.29) 179¶¶ 0.22 (0.19–0.25) 129## 0.37 (0.31–0.44)

*GBS, group B Streptococcus; GBS-CV, GBS polysaccharide–protein conjugate vaccine.
†HIV-exposed and -unexposed values were calculated on the basis of national HIV prevalence in pregnant women (29.5%). Incidence values represent cases/1,000 live births.
‡2012 live births.
§Overall GBS incidence is 2.72/1,000 live births.
¶GBS incidence for HIV-unexposed infants is 1.99/1,000 live births.
#GBS incidence in HIV-exposed infants is 4.48/1,000 live births.
**Total deaths in infants <90 days old, assuming 15.2% were born at <33 weeks of gestation and have a case-fatality rate (CFR) of 26.5% and assuming 84.8% were born at >33 weeks of gestation and have a CFR of 15.6%.
††Deaths in infants <90 days old who were born at >33 weeks of gestation (84.8% of infants); CFR 15.6%.
‡‡Trivalent GBS-CV contains serotypes Ia, Ib, and III, which account for 88.3% of cases.
§§Assuming vaccine efficacy of 75%.
¶¶Assuming vaccine efficacy of 85%.
##Assuming vaccine efficacy of 65%.
***Pentavalent GBS-CV contains serotypes Ia, Ib, II, III, and V, which account for 97.2% of cases.

Main Article

1Preliminary results from this study were presented at the 8th World Congress of the World Society for Pediatric Infectious Diseases, November 19–22, 2013, Cape Town, South Africa.

Page created: March 17, 2015
Page updated: March 17, 2015
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