title: Abnormal humoral immune response to influenza vaccination in pediatric type-1 human immunodeficiency virus infected patients receiving highly active antiretroviral therapy.
abstract: Given that highly active antiretroviral therapy (HAART) has been demonstrated useful to restore immune competence in type-1 human immunodeficiency virus (HIV-1)-infected subjects, we evaluated the specific antibody response to influenza vaccine in a cohort of HIV-1-infected children on HAART so as to analyze the quality of this immune response in patients under antiretroviral therapy. Sixteen HIV-1-infected children and 10 HIV-1 seronegative controls were immunized with a commercially available trivalent inactivated influenza vaccine containing the strains A/H1N1, A/H3N2, and B. Serum hemagglutinin inhibition (HI) antibody titers were determined for the three viral strains at the time of vaccination and 1 month later. Immunization induced a significantly increased humoral response against the three influenza virus strains in controls, and only against A/H3N2 in HIV-1-infected children. The comparison of post-vaccination HI titers between HIV-1+ patients and HIV-1 negative controls showed significantly higher HI titers against the three strains in controls. In addition, post vaccination protective HI titers (defined as equal to or higher than 1:40) against the strains A/H3N2 and B were observed in a lower proportion of HIV-1+ children than in controls, while a similar proportion of individuals from each group achieved protective HI titers against the A/H1N1 strain. The CD4+ T cell count, CD4/CD8 T cells ratio, and serum viral load were not affected by influenza virus vaccination when pre- vs post-vaccination values were compared. These findings suggest that despite the fact that HAART is efficient in controlling HIV-1 replication and in increasing CD4+ T cell count in HIV-1-infected children, restoration of immune competence and response to cognate antigens remain incomplete, indicating that additional therapeutic strategies are required to achieve a full reconstitution of immune functions.
authors.affiliation: Group of Immunovirology-Biogenesis, Universidad de Antioquia, Medellin, Columbia. cjmonto@une.net.co
authors.forename: Carlos J
authors.initials: CJ
authors.lastname: Montoya
authors.forename: Maria F
authors.initials: MF
authors.lastname: Toro
authors.forename: Carlos
authors.initials: C
authors.lastname: Aguirre
authors.forename: Alberto
authors.initials: A
authors.lastname: Bustamante
authors.forename: Mariluz
authors.initials: M
authors.lastname: Hernandez
authors.forename: Liliana P
authors.initials: LP
authors.lastname: Arango
authors.forename: Marta
authors.initials: M
authors.lastname: Echeverry
authors.forename: Ana E
authors.initials: AE
authors.lastname: Arango
authors.forename: Maria C
authors.initials: MC
authors.lastname: Prada
authors.forename: Herminia del P
authors.initials: Hdel P
authors.lastname: Alarcon
authors.forename: Mauricio
authors.initials: M
authors.lastname: Rojas
mesh_terms: D000914:Antibodies, Viral / Q000097:blood* / Q000276:immunology; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology; D015497:HIV-1 / Q000187:drug effects / Q000502:physiology; D006801:Humans; D009980:Influenza A virus / Q000276:immunology*; D009981:Influenza B virus / Q000276:immunology*; D007252:Influenza Vaccines / Q000276:immunology*; D007251:Influenza, Human / Q000276:immunology / Q000517:prevention & control*; D008297:Male; D015164:Vaccines, Inactivated / Q000276:immunology; D019562:Viral Load
chemical_list: D000914:Antibodies, Viral; D007252:Influenza Vaccines; D015164:Vaccines, Inactivated