Effectiveness of the polysaccharide pneumococcal vaccine among HIV-infected persons in Brazil: a case control study

Abstract Background Polysaccharide pneumococcal vaccine is recommended for use in HIV-infected adults in Brazil but there is uncertainty about its effectiveness in this patient population. The main objective of this study was to assess the effectiveness of the 23-valent polysaccharide pneumococcal vaccine against invasive pneumococcal infection among HIV-infected adult patients in São Paulo, Brazil. Methods A case-control study of 79 cases and 242 controls matched on CD4+ cell count and health care setting was conducted. Among HIV-infected adults in São Paulo, Brazil, with and without S. pneumoniae recovered from a normally sterile site; prior receipt of 23 valent polysaccharide pneumococcal vaccine was determined by review of medical records and patient interview. Results After adjustment for confounding factors, the point estimate for the effectiveness of 23 valent polysaccharide vaccine among HIV-infected adults against all invasive pneumococcal infection was 18% (95% CI: <0 to 62%). Conclusion We were unable to demonstrate a statistically significant protective effect of 23 valent polysaccharide against invasive pneumococcal infection vaccine among HIV-infected adults in Brazil. While the vaccine is relatively inexpensive and safe, its effectiveness among HIV-infected adults in Brazil is uncertain.

Low-temperature thermodynamic properties near the field-induced quantum critical point in NiCl2-4SC(NH2)(2)

We present a comprehensive experimental and theoretical investigation of the thermodynamic properties: specific heat, magnetization, and thermal expansion in the vicinity of the field-induced quantum critical point (QCP) around the lower critical field H-c1 approximate to 2 T in NiCl2-4SC(NH2)(2). A T-3/2 behavior in the specific heat and magnetization is observed at very low temperatures at H = H-c1, which is consistent with the universality class of Bose-Einstein condensation of magnons. The temperature dependence of the thermal expansion coefficient at H-c1 shows minor deviations from the expected T-1/2 behavior. Our experimental study is complemented by analytical calculations and quantum Monte Carlo simulations, which reproduce nicely the measured quantities. We analyze the thermal and the magnetic Gruneisen parameters, which are ideal quantities to identify QCPs. Both parameters diverge at H-c1 with the expected T-1 power law. By using the Ehrenfest relations at the second-order phase transition, we are able to estimate the pressure dependencies of the characteristic temperature and field scales.