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Humoral and cellular response to influenza vaccine in HIV-infected children with full viroimmunologic response to antiretroviral therapy.
J Acquir Immune Defic Syndr 2008; 48(3):289-96JA

Abstract

OBJECTIVE

It is unclear whether the ability to respond to vaccines is restored by antiretroviral therapy. We evaluated the influenza-specific immune responses elicited by a virosomal vaccine in HIV-infected children on long-term successful highly active antiretroviral therapy (HAART).

METHODS

This was an observational, prospective, open-label study enrolling 24 HIV-infected, HAART-treated (85 months' mean exposure), vaccine-naive children (median age=11.9 years) and 14 age- and gender-matched healthy controls. Mean CD4 T-cell counts (>900 cells/microL) and percentages (>37%) were comparable. The HIV RNA level was <50 copies/mL in all patients. Children received a single dose of trivalent virosome-adjuvanted influenza vaccine. A/H3N2-, A/H1N1-, and B-antigen-specific antibody (Ab) titers and subclasses and vaccine-specific interferon-gamma (IFNgamma)- and interleukin (IL)-2-producing T lymphocytes were analyzed at baseline and 1 and 6 months after immunization.

RESULTS

Seroconversion (>or=4-fold Ab titer raise in >40% of patients) and seroprotection (Ab titer>or=1:40 in >70% of patients) was achieved at 1 month in both groups; however, fewer HIV-infected children fulfilled these criteria. The A/H3N2- and A/H1N1-specific Ab geometric mean titers were lower in HIV-infected children compared with healthy controls at 1 and 6 months; interestingly, a boost in vaccine-specific IgG3 T helper 1 type Ab was seen in healthy controls alone. Finally, vaccine specific-IFNgamma- and IL-2-producing T lymphocytes were reduced at both time points in HIV-infected children compared with healthy controls.

CONCLUSIONS

One injection of virosomal-adjuvanted influenza vaccine stimulates good immune responses, although the humoral and cellular immune responses are reduced in HIV-infected children compared to healthy children. This indicates that immunologic function impairments may persist upon HIV infection even if HIV-positive viremia is suppressed and immune recovery seems to be achieved.

Authors+Show Affiliations

Clinic of Pediatrics, Luigi Sacco Hospital, University of Milan, Milan, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18545155

Citation

Viganò, Alessandra, et al. "Humoral and Cellular Response to Influenza Vaccine in HIV-infected Children With Full Viroimmunologic Response to Antiretroviral Therapy." Journal of Acquired Immune Deficiency Syndromes (1999), vol. 48, no. 3, 2008, pp. 289-96.
Viganò A, Zuccotti GV, Pacei M, et al. Humoral and cellular response to influenza vaccine in HIV-infected children with full viroimmunologic response to antiretroviral therapy. J Acquir Immune Defic Syndr. 2008;48(3):289-96.
Viganò, A., Zuccotti, G. V., Pacei, M., Erba, P., Castelletti, E., Giacomet, V., ... Clerici, M. (2008). Humoral and cellular response to influenza vaccine in HIV-infected children with full viroimmunologic response to antiretroviral therapy. Journal of Acquired Immune Deficiency Syndromes (1999), 48(3), pp. 289-96. doi:10.1097/QAI.0b013e3181632cda.
Viganò A, et al. Humoral and Cellular Response to Influenza Vaccine in HIV-infected Children With Full Viroimmunologic Response to Antiretroviral Therapy. J Acquir Immune Defic Syndr. 2008 Jul 1;48(3):289-96. PubMed PMID: 18545155.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Humoral and cellular response to influenza vaccine in HIV-infected children with full viroimmunologic response to antiretroviral therapy. AU - Viganò,Alessandra, AU - Zuccotti,Gian Vincenzo, AU - Pacei,Michela, AU - Erba,Paola, AU - Castelletti,Eleonora, AU - Giacomet,Vania, AU - Amendola,Antonella, AU - Pariani,Elena, AU - Tanzi,Elisabetta, AU - Clerici,Mario, PY - 2008/6/12/pubmed PY - 2008/7/17/medline PY - 2008/6/12/entrez SP - 289 EP - 96 JF - Journal of acquired immune deficiency syndromes (1999) JO - J. Acquir. Immune Defic. Syndr. VL - 48 IS - 3 N2 - OBJECTIVE: It is unclear whether the ability to respond to vaccines is restored by antiretroviral therapy. We evaluated the influenza-specific immune responses elicited by a virosomal vaccine in HIV-infected children on long-term successful highly active antiretroviral therapy (HAART). METHODS: This was an observational, prospective, open-label study enrolling 24 HIV-infected, HAART-treated (85 months' mean exposure), vaccine-naive children (median age=11.9 years) and 14 age- and gender-matched healthy controls. Mean CD4 T-cell counts (>900 cells/microL) and percentages (>37%) were comparable. The HIV RNA level was <50 copies/mL in all patients. Children received a single dose of trivalent virosome-adjuvanted influenza vaccine. A/H3N2-, A/H1N1-, and B-antigen-specific antibody (Ab) titers and subclasses and vaccine-specific interferon-gamma (IFNgamma)- and interleukin (IL)-2-producing T lymphocytes were analyzed at baseline and 1 and 6 months after immunization. RESULTS: Seroconversion (>or=4-fold Ab titer raise in >40% of patients) and seroprotection (Ab titer>or=1:40 in >70% of patients) was achieved at 1 month in both groups; however, fewer HIV-infected children fulfilled these criteria. The A/H3N2- and A/H1N1-specific Ab geometric mean titers were lower in HIV-infected children compared with healthy controls at 1 and 6 months; interestingly, a boost in vaccine-specific IgG3 T helper 1 type Ab was seen in healthy controls alone. Finally, vaccine specific-IFNgamma- and IL-2-producing T lymphocytes were reduced at both time points in HIV-infected children compared with healthy controls. CONCLUSIONS: One injection of virosomal-adjuvanted influenza vaccine stimulates good immune responses, although the humoral and cellular immune responses are reduced in HIV-infected children compared to healthy children. This indicates that immunologic function impairments may persist upon HIV infection even if HIV-positive viremia is suppressed and immune recovery seems to be achieved. SN - 1525-4135 UR - https://www.unboundmedicine.com/medline/citation/18545155/Humoral_and_cellular_response_to_influenza_vaccine_in_HIV_infected_children_with_full_viroimmunologic_response_to_antiretroviral_therapy_ L2 - http://Insights.ovid.com/pubmed?pmid=18545155 DB - PRIME DP - Unbound Medicine ER -