Anti-influenza serum and mucosal antibody responses after administration of live attenuated or inactivated influenza vaccines to HIV-infected children.
BACKGROUND
Live-attenuated influenza vaccine (LAIV) prevents more cases of influenza in immune-competent children than the trivalent inactivated vaccine (TIV). We compared the antibody responses to LAIV or TIV in HIV-infected children.


METHODS
Blood and saliva obtained at enrollment, 4 and 24 weeks postimmunization from 243 HIV-infected children randomly assigned to TIV or LAIV were analyzed.


RESULTS
Both vaccines increased the anti-influenza neutralizing antibodies at 4 and 24 weeks postimmunization. At 4 weeks postimmunization, TIV recipients had 2-fold to 3-fold higher neutralizing antibody titers than LAIV recipients, but the proportions of subjects with protective titers (≥ 1:40) were similar between treatment groups (96%-100% for influenza A and 81%-88% for influenza B). Both vaccines increased salivary homotypic IgG antibodies, but not IgA antibodies. Both vaccines also increased serum heterosubtypic antibodies. Among HIV-specific characteristics, the baseline viral load correlated best with the antibody responses to either vaccine. We used LAIV-virus shedding as a surrogate of influenza infection. Influenza-specific humoral and mucosal antibody levels were significantly higher in nonshedders than in shedders.


CONCLUSIONS
LAIV and TIV generated homotypic and heterosubtypic humoral and mucosal antibody responses in HIV-infected children. High titers of humoral or mucosal antibodies correlated with protection against viral shedding.
Weinberg
Adriana
A
Department of Pediatrics, University of Colorado Denver, Aurora, CO, USA.
Song
Lin-Ye
LY
Walker
Robert
R
Allende
Maria
M
Fenton
Terence
T
Patterson-Bartlett
Julie
J
Nachman
Sharon
S
Kemble
George
G
Yi
Ting-Ting
TT
Defechereux
Patricia
P
Wara
Diane
D
Read
Jennifer S
JS
Levin
Myron
M
D000293:Adolescent; D057134:Antibodies, Neutralizing / Q000276:immunology; D000914:Antibodies, Viral / Q000097:blood* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000276:immunology*; D006801:Humans; D018928:Immunity, Mucosal / Q000276:immunology; D009980:Influenza A virus / Q000276:immunology; D009981:Influenza B virus / Q000276:immunology; D007252:Influenza Vaccines / Q000276:immunology / Q000494:pharmacology*; D008297:Male; D012463:Saliva / Q000276:immunology; D014613:Vaccines, Attenuated / Q000276:immunology / Q000494:pharmacology; D015164:Vaccines, Inactivated / Q000276:immunology / Q000494:pharmacology; D017201:Virus Shedding / Q000276:immunology
D057134:Antibodies, Neutralizing; D000914:Antibodies, Viral; D007252:Influenza Vaccines; D014613:Vaccines, Attenuated; D015164:Vaccines, Inactivated