Background: Children living with HIV (CLHIV) remain at increased risk for colonization and invasive disease by Neisseria meningitidis and Streptococcus pneumoniae despite antiretroviral therapy (ART) and vaccination. Data on nasopharyngeal carriage in this group are limited in Türkiye. Methods: In this multicenter prospective study, nasopharyngeal swabs were obtained from 80 CLHIV and 180 age-matched healthy controls between July and December 2024 in İstanbul and İzmir. Samples were analyzed by real-time PCR for Neisseria meningitidis and Streptococcus pneumoniae and meningococcal serogroups and pneumococcal serotypes were determined by molecular methods including capsular sequence typing. Demographic, clinical, and vaccination data were collected. Univariate and multivariate analyses assessed factors associated with carriage. Results: Meningococcal carriage was detected in 3/80 (3.8%) CLHIV and 16/180 (8.9%) controls (p = 0.15). All meningococcal isolates from CLHIV were non-groupable and were unvaccinated. Pneumococcal carriage occurred in 23/80 (28.7%) CLHIV and 43/180 (23.9%) controls (p = 0.40). Among CLHIV isolates, 65.2% were PCV13 serotypes, 26.1% were non-PCV13 serotypes, and 8.7% were non-typeable. Time since the last PCV13 dose was weakly but independently associated with lower pneumococcal carriage (adjusted OR per month 0.98, 95% CI 0.97–0.99; p = 0.011), while having vaccinated siblings showed a borderline protective effect. Conclusions: In this contemporary cohort from Türkiye, CLHIV exhibited low meningococcal carriage dominated by non-groupable strains and pneumococcal carriage comparable to healthy children, with a serotype distribution shaped by vaccination and host immunity. These findings support sustained risk-group vaccination, reinforcement of household-level immunization, and continued molecular surveillance to optimize prevention strategies for children living with HIV.
Atasever et al. (Tue,) studied this question.