Compromised B cell responses to influenza vaccination in HIV-infected individuals.
BACKGROUND
Yearly influenza vaccination, although recommended for human immunodeficiency virus (HIV)-infected individuals, has not received thorough evaluation in the era of antiretroviral therapy. We assessed the impact of HIV disease on B cell responses to influenza vaccination.


METHODS
Sixty-four HIV-infected and 17 HIV-negative individuals received the 2003-2004 trivalent inactivated influenza vaccine. Frequencies of influenza-specific antibody-secreting cells (ASCs) were measured by enzyme-linked immunospot (ELISPOT) assay, and antibody responses were measured by hemagglutination-inhibition (HI) assay. Memory responses to influenza were measured by ELISPOT assay after polyclonal activation of B cells in vitro.


RESULTS
Prevaccination HI titers were significantly higher in HIV-negative than in HIV-infected individuals. Peak HI titers and influenza-specific ASC frequencies were directly correlated with CD4+ T cell counts in HIV-infected individuals. Influenza-specific memory B cell responses were significantly lower in HIV-infected than in HIV-negative individuals and were directly correlated with CD4+ T cell counts.


CONCLUSIONS
HIV infection is associated with a weak antibody response to influenza vaccination that is compounded by a poor memory B cell response. CD4+ T cell count is a critical determinant of responsiveness to influenza vaccination, and the contribution of plasma HIV RNA level is suggestive and warrants further investigation.
Malaspina
Angela
A
Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland 20892, USA.
Moir
Susan
S
Orsega
Susan M
SM
Vasquez
Joshua
J
Miller
Natalie J
NJ
Donoghue
Eileen T
ET
Kottilil
Shyamasundaran
S
Gezmu
Misrak
M
Follmann
Dean
D
Vodeiko
Galina M
GM
Levandowski
Roland A
RA
Mican
JoAnn M
JM
Fauci
Anthony S
AS
D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology*; D018791:CD4 Lymphocyte Count; D006678:HIV / Q000235:genetics / Q000302:isolation & purification; D015658:HIV Infections / Q000276:immunology*; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000009:adverse effects*; D007273:Injections, Intramuscular; D007700:Kinetics; D018655:Lymphocyte Count; D012367:RNA, Viral / Q000097:blood / Q000302:isolation & purification; D013601:T-Lymphocytes / Q000276:immunology; D019562:Viral Load
D007252:Influenza Vaccines; D012367:RNA, Viral