The influence of human immunodeficiency virus (HIV) infection on antibody responses to influenza vaccines.
OBJECTIVE
To ascertain whether subjects infected with human immunodeficiency virus (HIV) generally develop protective hemagglutination inhibition antibody responses to inactivated influenza vaccines.


METHODS
Prospective study of 104 persons before and after immunization.


METHODS
Outpatient clinic and hospital ward.


METHODS
Persons with the acquired immunodeficiency syndrome (AIDS) (n = 25), AIDS-related complex (n = 14), and HIV-seropositive men with only lymphadenopathy or no symptoms (n = 27). Controls were HIV-seronegative homosexual men (n = 22) and HIV-seronegative heterosexuals (n = 16).


METHODS
Subjects were immunized with inactivated vaccines containing 15 micrograms of each of the following influenza virus hemagglutinins: A/Taiwan/1/86 (HINI), A/Mississippi/1/85 (H3N2), A/Chile/1/83 (HINI), and B/Ann Arbor/1/86.


RESULTS
Fourfold or greater antibody responses occurred less frequently in subjects with HIV infections than in HIV-seronegative controls. Protective levels (1:64 or greater) of hemagglutination inhibition antibodies were attained by 94% to 100% of HIV-seronegative controls, 52% to 89% of HIV-seropositive asymptomatic subjects, and 13% to 50% of subjects with AIDS or AIDS-related complex. No increase in the prevalence or level of serum HIV p24 antigen or clinical deterioration was detected among HIV-infected persons after influenza immunization.


CONCLUSIONS
Because of the poor antibody responses to influenza vaccines among HIV-infected subjects, even in many with no or minimal symptoms, alternative strategies for preventing influenza, such as booster doses of influenza vaccine, prophylaxis with amantidine, or both should be considered.
Nelson
K E
KE
Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland.
Clements
M L
ML
Miotti
P
P
Cohn
S
S
Polk
B F
BF
D000386:AIDS-Related Complex / Q000276:immunology; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000276:immunology*; D000328:Adult; D000914:Antibodies, Viral / Q000096:biosynthesis*; D000998:Antiviral Agents / Q000627:therapeutic use; D016655:HIV Core Protein p24; D006679:HIV Seropositivity / Q000276:immunology*; D006385:Hemagglutination Inhibition Tests; D006801:Humans; D009980:Influenza A virus / Q000276:immunology; D009981:Influenza B virus / Q000276:immunology; D007252:Influenza Vaccines / Q000276:immunology*; D007958:Leukocyte Count; D008297:Male; D011446:Prospective Studies; D012191:Retroviridae Proteins / Q000097:blood; D006377:T-Lymphocytes, Helper-Inducer; D013936:Thymidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D014758:Viral Core Proteins / Q000097:blood; D015215:Zidovudine
D000914:Antibodies, Viral; D000998:Antiviral Agents; D016655:HIV Core Protein p24; D007252:Influenza Vaccines; D012191:Retroviridae Proteins; D014758:Viral Core Proteins; D015215:Zidovudine; D013936:Thymidine