title: Compromised B cell responses to influenza vaccination in HIV-infected individuals.
abstract: 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.
authors.affiliation: Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland 20892, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Malaspina
authors.forename: Susan
authors.initials: S
authors.lastname: Moir
authors.forename: Susan M
authors.initials: SM
authors.lastname: Orsega
authors.forename: Joshua
authors.initials: J
authors.lastname: Vasquez
authors.forename: Natalie J
authors.initials: NJ
authors.lastname: Miller
authors.forename: Eileen T
authors.initials: ET
authors.lastname: Donoghue
authors.forename: Shyamasundaran
authors.initials: S
authors.lastname: Kottilil
authors.forename: Misrak
authors.initials: M
authors.lastname: Gezmu
authors.forename: Dean
authors.initials: D
authors.lastname: Follmann
authors.forename: Galina M
authors.initials: GM
authors.lastname: Vodeiko
authors.forename: Roland A
authors.initials: RA
authors.lastname: Levandowski
authors.forename: JoAnn M
authors.initials: JM
authors.lastname: Mican
authors.forename: Anthony S
authors.initials: AS
authors.lastname: Fauci
mesh_terms: 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
chemical_list: D007252:Influenza Vaccines; D012367:RNA, Viral