title: Immunologic and virologic evaluation after influenza vaccination of HIV-1-infected patients.
abstract: OBJECTIVE
  The present study was designed to determine the effect of immune activation, achieved by influenza vaccination, on plasma HIV RNA levels and immunological parameters including CD4 cell levels, antigen-stimulated T-cell function and apoptotic death of peripheral blood mononuclear cells.
  
  
  METHODS
  Thirty-four HIV-infected individuals and nine uninfected controls were immunized with influenza vaccine and blood was collected at weeks 0, 2, 4 and 16. Plasma was isolated and used for HIV RNA and influenza-specific antibody qualifications. CD4 cell counts, activation and maturation markers of T-lymphocyte subsets were determined by flow cytometry. In vitro T-helper responses, spontaneous- and activation-induced cell death assays were also performed.
  
  
  RESULTS
  Influenza-specific humoral and cellular immune responses correlated with CD4 count. Only in patients with CD4 counts > 300 x 10(6)/l there was a modest increase in T-cell responses to influenza virus, which was less than control subjects, observed after vaccination. Immunization had no significant effect on CD4 counts or plasma viral levels in the HIV-positive patients. Baseline apoptosis inversely correlated with CD4 counts and directly correlated with viral load. Activation-induced apoptosis did not change appreciably after vaccination and spontaneous apoptosis increased only in the < 300 CD4 group.
  
  
  CONCLUSIONS
  These results indicate that immune stimulation resulting from influenza vaccination did not significantly change the levels of plasma virus, CD4 cell counts, or activation-induced apoptosis in HIV-infected individuals, although an increase in the T-cell response to influenza and spontaneous apoptosis was observed in the > 300 and < 300 CD4 groups, respectively.
authors.affiliation: Experimental Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, USA.
authors.forename: K R
authors.initials: KR
authors.lastname: Fowke
authors.forename: R
authors.initials: R
authors.lastname: D'Amico
authors.forename: D N
authors.initials: DN
authors.lastname: Chernoff
authors.forename: J C
authors.initials: JC
authors.lastname: Pottage
authors.forename: C A
authors.initials: CA
authors.lastname: Benson
authors.forename: B E
authors.initials: BE
authors.lastname: Sha
authors.forename: H A
authors.initials: HA
authors.lastname: Kessler
authors.forename: A L
authors.initials: AL
authors.lastname: Landay
authors.forename: G M
authors.initials: GM
authors.lastname: Shearer
mesh_terms: D000914:Antibodies, Viral / Q000276:immunology; D017209:Apoptosis; D018791:CD4 Lymphocyte Count; D005434:Flow Cytometry; D015658:HIV Infections / Q000276:immunology* / Q000821:virology*; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D008213:Lymphocyte Activation; D012367:RNA, Viral / Q000097:blood; D006377:T-Lymphocytes, Helper-Inducer / Q000166:cytology / Q000276:immunology; D014611:Vaccination
chemical_list: D000914:Antibodies, Viral; D007252:Influenza Vaccines; D012367:RNA, Viral