title: The influence of human immunodeficiency virus (HIV) infection on antibody responses to influenza vaccines.
abstract: 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.
authors.affiliation: Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland.
authors.forename: K E
authors.initials: KE
authors.lastname: Nelson
authors.forename: M L
authors.initials: ML
authors.lastname: Clements
authors.forename: P
authors.initials: P
authors.lastname: Miotti
authors.forename: S
authors.initials: S
authors.lastname: Cohn
authors.forename: B F
authors.initials: BF
authors.lastname: Polk
mesh_terms: 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
chemical_list: 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