Influence of antiretroviral therapy on immunogenicity of simultaneous vaccinations against influenza, pneumococcal disease and hepatitis A and B in human immunodeficiency virus positive individuals.
OBJECTIVE
Immune response to many vaccinations is impaired in human immunodeficiency virus (HIV) positive patients.


METHODS
A total of n = 131 HIV positive patients were vaccinated against influenza, pneumococcal disease, hepatitis A and B, with n = 82 patients (62.6%) receiving 2 or more simultaneous vaccinations. Safety and immunogenicity of simultaneous vaccinations were assessed. Current antiretroviral therapy (ART) regimens were evaluated as potential predictors for antibody response.


RESULTS
Immune response rates were 45% (influenza), 68% (pneumococcus), 63.6% (hepatitis A) and 62.5% (hepatitis B). Adverse reactions after vaccination were documented in 2 of 131 patients (1.5%). No statistically significant difference between pre- and post-vaccination CD4+ T-cell counts (CD4) and HIV plasma load was observed. 85% of patients received ART containing nucleotide reverse transcriptase inhibitors, non-nucleotide reverse transcriptase inhibitors and/or protease inhibitors (PI). Higher ratio of CD4 to CD8 and intake of PI were statistically significant, independent predictors for antibody response after influenza vaccination (OR 1.9 and 2.8, p = 0.01 and 0.04, respectively).


CONCLUSIONS
Simultaneous vaccinations in HIV positive patients were safe and well tolerated. The positive effect of PI on antibody response after influenza vaccination should be confirmed in larger studies.
Horster
S
S
Medizinische Klinik II, Campus Großhadern, Ludwig-Maximilians-University, Marchioninistr. 15, 81377 Munich, Germany. Sophia.Horster@med.uni-muenchen.de
Laubender
R P
RP
Lehmeyer
L
L
Ankerst
D P
DP
Eberle
J
J
Reinert
R
R
Imöhl
M
M
van der Linden
M
M
Schweiger
B
B
Bogner
J R
JR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology*; D022362:Hepatitis A Vaccines / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology*; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology*; D019562:Viral Load; D055815:Young Adult
D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D022362:Hepatitis A Vaccines; D017325:Hepatitis B Vaccines; D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines