Efficacy of influenza vaccination in HIV-infected persons. A randomized, double-blind, placebo-controlled trial.
BACKGROUND
Although influenza vaccination is recommended in persons infected with HIV-1, its efficacy is unknown.


OBJECTIVE
To assess the immunogenicity, efficacy, and risks associated with influenza vaccination in persons infected with HIV-1.


METHODS
Randomized, double-blind, placebo-controlled trial.


METHODS
Outpatient military clinic.


METHODS
102 patients with HIV-1 infection.


METHODS
Influenza vaccine (n = 55) or saline placebo (n = 47).


METHODS
Influenza antibody titers, CD4+ cell counts, and plasma HIV-1 RNA levels at baseline, 1 month after immunization, and 3 months after immunization; viral cultures from persons presenting with respiratory illness; and respiratory symptom interview.


RESULTS
Twenty-three placebo recipients (49%) and 16 vaccine recipients (29%) reported respiratory symptoms (P = 0.04). Ten placebo recipients but no vaccine recipients had laboratory-confirmed symptomatic influenza (P < 0.001) (protective efficacy, 100% [95% CI, 73% to 100%]). No effect on plasma HIV-1 RNA levels or CD4+ cell counts was noted.


CONCLUSIONS
Influenza vaccination is highly effective in HIV-1-infected persons and does not seem to be associated with substantial changes in viral load or CD4 cell count.
Tasker
S A
SA
Infectious Diseases Division, U.S. Naval Medical Center, San Diego, California 92134-5000, USA.
Treanor
J J
JJ
Paxton
W B
WB
Wallace
M R
MR
D018791:CD4 Lymphocyte Count; D004311:Double-Blind Method; D015658:HIV Infections / Q000276:immunology* / Q000821:virology; D015497:HIV-1 / Q000235:genetics; D006801:Humans; D016867:Immunocompromised Host; D009980:Influenza A virus; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000517:prevention & control*; D012367:RNA, Viral / Q000097:blood; D014611:Vaccination; D019562:Viral Load
D007252:Influenza Vaccines; D012367:RNA, Viral