Efficacy and immunologic responses to influenza vaccine in HIV-1-infected patients.
Influenza vaccine is recommended for HIV-1-infected patients. The present prospective study was conducted to evaluate the clinical efficacy and immunologic responses to the vaccine. From November 1 to December 27, 2002, 262 HIV-1-infected patients received a trivalent influenza subunit vaccine, whereas 66 did not. Influenza illness occurred in 16 vaccinated and 14 nonvaccinated patients (incidence = 6.1% [95% confidence interval (CI): 4%-10%] in vaccinated vs. 21.2% [CI: 13%-35%] in nonvaccinated persons, P < 0.001; relative risk = 0.29 [CI: 0.14-0.55]). Influenza vaccine provided clinically effective protection against influenza illness in HIV-1-infected patients. In baseline antibody-negative patients, anti-H1 and anti-H3 antibody responses to the vaccination were significant in those patients with a CD4 count >200 cells/muL compared with those with a CD4 count <200 cells/muL (P < 0.05). In contrast, in baseline antibody-positive patients, good antibody responses were observed irrespective of CD4 counts, like the healthy controls. Based on these results, annual vaccination is recommended. Specific CD4 responses correlated with HIV-1 viral load (VL), especially in patients treated with highly active antiretroviral therapy (HAART) compared with those without HAART (P < 0.01), although the clinical efficacy did not correlate with HIV-1 VL. HAART may enhance the immunologic efficacy of influenza vaccine.
Yamanaka
Hikaru
H
AIDS Clinical Center, International Medical Center of Japan, Tokyo, Japan.
Teruya
Katsuji
K
Tanaka
Mari
M
Kikuchi
Yoshimi
Y
Takahashi
Takao
T
Kimura
Satoshi
S
Oka
Shinichi
S
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000276:immunology*; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D016001:Confidence Intervals; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology*; D006389:Hemagglutinins, Viral / Q000276:immunology; D006801:Humans; D009980:Influenza A virus; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000175:diagnosis* / Q000276:immunology; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D000914:Antibodies, Viral; D006389:Hemagglutinins, Viral; D007252:Influenza Vaccines