title: Safety and immunogenicity of influenza vaccine among HIV-infected adults: Conventional vaccine vs. intradermal vaccine.
abstract: Several studies have reported poor immune responses to conventional influenza vaccines in HIV-infected individuals. This study sought to elicit more potent immunogenicity in HIV-infected adults using an intradermal vaccine compared with a conventional intramuscular vaccine. This multicenter, randomized, controlled, open-label study was conducted at 3 university hospitals during the 2011/2012 pre-influenza season. Three vaccines were used in HIV-infected adults aged 18 - 60 years: an inactivated intramuscular vaccine (Agrippal), a reduced-content intradermal vaccine (IDflu9μg) and a standard-content intradermal vaccine (IDflu15μg). Serum hemagglutination-inhibiting (HI) antibodies and INF-γ ELISpot assay were measured at the time of vaccination and 1 month after vaccination. Adverse events were recorded for 7 d. A total of 28 Agrippal, 30 IDflu9μg, and 28 IDflu15μg volunteers were included in this analysis. One month after vaccination, the GMTs and differences in INF-γ ELISpot assay results were similar among the 3 groups. Seroprotection rates, seroconversion rates and mean fold increases (MFI) among the 3 groups were also similar, at approximately 80%, 50-60% and 2.5 - 10.0, respectively. All three vaccines satisfied the CHMP criteria for the A/H1N1 and A/H3N2 strains, but not those for the B strain. In univariate analysis, no demographic or clinical factors, including age, CD4+ T-cell counts, HIV viral load, ART status and vaccine type, were related to failure to achieve seroprotection. The three vaccines were all well-tolerated and all reported reactions were mild to moderate. However, there was a tendency toward a higher incidence of local and systemic reactions in the intradermal vaccine groups. The intradermal vaccine did not result in higher immunogenicity compared to the conventional intramuscular vaccine, even with increased antigen dose.
authors.affiliation: a Division of Infectious Diseases ; Department of Internal Medicine; Hallym University College of Medicine ; Chuncheon , Republic of Korea.
authors.forename: Yu Bin
authors.initials: YB
authors.lastname: Seo
authors.affiliation: a Division of Infectious Diseases ; Department of Internal Medicine; Hallym University College of Medicine ; Chuncheon , Republic of Korea.
authors.forename: Jacob
authors.initials: J
authors.lastname: Lee
authors.affiliation: b Division of Infectious Diseases ; Department of Internal Medicine; Korea University College of Medicine ; Seoul , Republic of Korea.
authors.forename: Joon Young
authors.initials: JY
authors.lastname: Song
authors.affiliation: c Division of Infectious Diseases ; Department of Internal Medicine; Ewha Woman University College of Medicine ; Seoul , Republic of Korea.
authors.forename: Hee Jung
authors.initials: HJ
authors.lastname: Choi
authors.affiliation: b Division of Infectious Diseases ; Department of Internal Medicine; Korea University College of Medicine ; Seoul , Republic of Korea.
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Cheong
authors.affiliation: b Division of Infectious Diseases ; Department of Internal Medicine; Korea University College of Medicine ; Seoul , Republic of Korea.
authors.forename: Woo Joo
authors.initials: WJ
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D005260:Female; D015658:HIV Infections / Q000276:immunology; D006801:Humans; D000071497:Immunogenicity, Vaccine / Q000276:immunology*; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D053122:Influenza A Virus, H3N2 Subtype / Q000276:immunology*; D009981:Influenza B virus / Q000276:immunology*; D007252:Influenza Vaccines / Q000009:adverse effects* / Q000276:immunology*; D007271:Injections, Intradermal; D007273:Injections, Intramuscular; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D015164:Vaccines, Inactivated / Q000276:immunology; D019562:Viral Load / Q000276:immunology; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines; D015164:Vaccines, Inactivated
keywords: HIV; immunogenicity; influenza vaccine; intradermal vaccine; safety