Journal Article

Influenza Vaccination of Human Immunodeficiency Virus (HIV)-Infected Adults: Impact on Plasma Levels of HIV Type 1 RNA and Determinants of Antibody Response

Jon D. Fuller, Donald E. Craven, Kathleen A. Steger, Nancy Cox, Timothy C. Heeren and David Chernoff

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 28, issue 3, pages 541-547
Published in print March 1999 | ISSN: 1058-4838
Published online March 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515170
Influenza Vaccination of Human Immunodeficiency Virus (HIV)-Infected Adults: Impact on Plasma Levels of HIV Type 1 RNA and Determinants of Antibody Response

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We assessed the effect of influenza vaccination on plasma levels of human immunodeficiency virus type 1 (HIV-1) RNA and the impact of age, plasma HIV-1 RNA level, CD4 cell count, and anti-HIV therapy on immune response. Forty-nine adults (mean age, 38.7 years; mean CD4 cell count ±SD, 190 ± 169/mL; mean plasma HIV-1 RNA level ± SD, 154,616 ± 317,192 copies/mL) were immunized. Elevations of ⩾0.48 log in plasma HIV-1 RNA levels occurred in two (4%) of 49 subjects within 4 weeks of vaccination. A fourfold or greater increase in antibody titer occurred in 13 (45%) of 29 subjects, correlating directly with CD4 cell count (P = .002) and inversely with plasma HIV-1 RNA level (P = .034). By multivariate analysis, CD4 cell count was a stronger predictor of antibody response than was plasma HIV-1 RNA level. We conclude that increases in plasma HIV-1 RNA levels following influenza vaccination are rare and transient and that antibody response is impaired with CD4 cell counts of <100/mL and plasma HIV-1 RNA levels of >100,000 copies/mL. Prospective trials are needed to evaluate the impact of highly active therapy on immune response after vaccination.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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