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Stimulating Evidence for Pneumococcal Conjugate Vaccination Among HIV-Infected Adults.

Streptococcus pneumoniae remains a formidable foe—it is the leading cause of bacterial pneumonia and an important cause of invasive disease. Adults infected with human immunodeficiency virus (HIV) are at particular risk for invasive pneumococcal disease (IPD), with an approximate 40-fold risk compared with the general population despite the advent of combination antiretroviral therapy (cART) [1–3]. Furthermore, up to 25% of HIV-infected persons develop recurrent disease, most commonly because of reinfection [4, 5]. The annual IPD incidence of 245 cases per 100 000 among HIV-positive adults in the developed world [2 ] points to the need for additional modalities to prevent this all too common infection. The burden of pneumococcal disease