Effects of influenza vaccination in HIV-infected adults: a double-blind, placebo-controlled trial.
Annual influenza vaccine is recommended for persons with HIV infection. Recent reports indicate that immunizations may increase HIV replication in infected individuals. Forty-seven HIV-infected patients were randomized to influenza vaccine or saline placebo using a double blind study design. One month after vaccination, plasma HIV-1 RNA increased in the vaccinated but not placebo group (p = 0.029). At 3 months, CD4% dropped an average of 1.6 points in the vaccinated group compared to an increase of 0.1 points in the placebo group (p = 0.039). Patients on stable antiretroviral regimens had CD4% drop an average of 2.3 points in the vaccinated group at 3 months versus 0.1 points in the placebo group (p = 0.015). It is concluded that HIV-infected patients are at risk for increased HIV replication and decreases in CD4% following influenza vaccination. Since influenza has not been associated with significant morbidity in this population, further study of routine influenza vaccination for HIV-infected patients is warranted.
Department of Internal Medicine (Infectious Diseases Division), Naval Medical Centre, San Diego, CA 92134-5000, USA.
S A
SA
Tasker
W A
WA
O'Brien
J J
JJ
Treanor
P J
PJ
Weiss
P E
PE
Olson
A H
AH
Kaplan
M R
MR
Wallace
D017088:AIDS-Related Opportunistic Infections / Q000276:immunology / Q000517:prevention & control; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D018791:CD4 Lymphocyte Count; D004311:Double-Blind Method; D005260:Female; D015658:HIV Infections / Q000276:immunology* / Q000628:therapy* / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification / Q000502:physiology; D006801:Humans; D007252:Influenza Vaccines / Q000009:adverse effects / Q000276:immunology / Q000494:pharmacology*; D007251:Influenza, Human / Q000150:complications / Q000276:immunology / Q000517:prevention & control; D008297:Male; D009975:Orthomyxoviridae / Q000276:immunology; D012367:RNA, Viral / Q000097:blood; D014766:Viremia / Q000276:immunology / Q000628:therapy / Q000821:virology; D014779:Virus Replication
D000914:Antibodies, Viral; D007252:Influenza Vaccines; D012367:RNA, Viral