Clinical Drug Investigation

, Volume 17, Issue 6, pp 441–449

Humoral Response to Influenza Vaccination in HIV-Infected Patients

  • Lidia B. Brydak
  • Henryk Jan Hryniewicz
  • Magdalena Machala
  • Andrzej Horban
Clinical Pharmacodynamic

Abstract

Objective: To assess the humoral response in HIV-infected adults immunised against influenza in Poland in the epidemic season 1997/98.

Patients and Methods: The study was carried out in 34 HIV-infected patients in different stages of the disease, vaccinated with a single 0.5ml dose of subunit vaccine (‘Influvac’, Solvay Pharmaceuticals BV). Antihaemagglutinin (HI) antibody levels were measured by the haemagglutinin inhibition test before immunisation and then after one and six months.

Results: One month after vaccination HI antibody titres significantly increased from 1.5 to 5.5 times. After six months HI antibody levels were higher than those before vaccination and also higher than those determined one month after vaccination. Before immunisation the number of patients with HI antibody titres ≥l:40 ranged from 2.9 to 50%. After vaccination, protection rates increased and ranged from 17.6 to 79.4% one month after vaccination, and from 20.6 to 82.4% six months after vaccination. Response rate values remained at similar levels during the whole study and were between 9.4 and 14.7%. No statistically significant differences were found in humoral response between patients with different CD4 counts nor between AIDS patients and those not suffering from AIDS. Significantly higher antibody titres were recorded during the whole study for the A/Wuhan/359/95 (H3N2) influenza strain than for the A(H1N1) and B strains.

Conclusions: The results of this study indicated that in HIV-infected patients humoral response to influenza vaccination was poor compared with healthy people. However, in some HIV-infected patients the vaccine induced the production of HI antibodies in titres that were considered high enough to protect against the infection.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Brydak LB, editor. Influenza and its prophylaxis. Warsaw: Springer PWN, 1998Google Scholar
  2. 2.
    Brydak LB. Influenza vaccination policy in Poland. European Scientific Working Group on Influenza. Information and news on influenza. Influenza Bulletin 1998; 9: 7–8Google Scholar
  3. 3.
    Centers for Disease Control and Prevention. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 1998; 47(RR-6): 4–7Google Scholar
  4. 4.
    Sorvillo FJ, Nahlen BL. Influenza immunization for HTV-infected persons in Los Angeles. Vaccine 1995; 13(4): 377–80PubMedCrossRefGoogle Scholar
  5. 5.
    Cohen JP, Macauley C. Susceptibility to influenza A in HIV-positive patients. JAMA 1989; 261: 245PubMedCrossRefGoogle Scholar
  6. 6.
    Cohn D. Bacterial pneumonia in the HIV-infected patients. Infect Dis Clinic North Am 1991; 5: 485–507Google Scholar
  7. 7.
    Thurn JR, Henry K. Influenza A pneumonitis in a patient infected with the human immunodeficiency virus (HIV). Chest 1989; 95: 807–10PubMedCrossRefGoogle Scholar
  8. 8.
    Nelson KE, Clements ML, Miotti P, et al. The influence of human immunodeficiency virus (HIV) infection on antibody responses to influenza vaccines. Ann Intern Med 1988; 109: 383–8PubMedGoogle Scholar
  9. 9.
    Kroon FP, Van Dissel JT, De Jong JC, et al. Antibody response to influenza, tetanus and pneumococcal vaccines in HTV-seropositive individuals in relation to the number of CD+ lymphocytes. AIDS 1994; 8: 469–76PubMedCrossRefGoogle Scholar
  10. 10.
    Tasker SA, O’Brien WA, Treanor JJ, et al. Effects of influenza vaccination in HIV-infected adults: a double-blind, placebo-controlled trial. Vaccine 1998; 16(9/10): 1039–42PubMedCrossRefGoogle Scholar
  11. 11.
    Glesby MJ, Hoover DR, Farzadegan H, et al. The effect of influenza vaccination on human immunodeficiency virus type 1 load: a randomized, double-blind, placebo-controlled study. J Infect Dis 1996; 174: 1332–6PubMedCrossRefGoogle Scholar
  12. 12.
    Centers for Disease Control. 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR Morbid Mortal Wkly Rep 1992; 41(RR-17): 1–19Google Scholar
  13. 13.
    Brydak LB, Rokicka-Milewska R, Jackowska T, et al. Kinetics of humoral response in children with acute lymphoblastic leukemia immunized with influenza vaccine in 1993 in Poland. Leuk Lymphoma 1997; 26: 163–9PubMedGoogle Scholar
  14. 14.
    Brydak LB, Rokicka-Milewska R, Machala M, et al. Immuno-genicity of subunit trivalent influenza vaccine in children with acute lymphoblastic leukemia. Pediatr Infect Dis J 1998; 17: 125–9PubMedCrossRefGoogle Scholar
  15. 15.
    Brydak LB, Calbecka M. Immunogenicity against influenza in patients with blood cancer disease. Leuk Lymphoma 1999; 32(3-4): 369–74PubMedGoogle Scholar
  16. 16.
    Brydak LB, Rokicka-Milewska R, Machala M, et al. Studies on the humoral immune response to hemagglutinin of influenza vaccine in children with acute lymphoblastic leukemia after chemotherapy treatment. Int J Pediatr Hematol/Oncol. In pressGoogle Scholar
  17. 17.
    Brydak L, Rokicka-Milewska R, Klukowska A, et al. Antibody kinetics in children with hemophilia immunized with influenza vaccine in 1993 in Poland. Int J Pediatr Hematology/ Oncology 1998; 5(1): 13–9Google Scholar
  18. 18.
    Brydak LB, Rajkowski T, Machala M, et al. Humoral antibody response following influenza vaccination in patients with nephrotic syndrome. Antiinfect Drugs Chemother 1998; 16(2): 151–5Google Scholar
  19. 19.
    Brydak LB, Rokicka-Milewska R, Machala M, et al. Efficacy of subunit trivalent influenza vaccine in previously vaccinated children suffering from hemophilia. Clin Microbiol Infect 1998; 4(10): 589–93PubMedCrossRefGoogle Scholar
  20. 20.
    Birx DL, Rhoads JL, Wright JC, et al. Immunologic parameters in early stage HIV-seropositive subjects associated with vaccine responsiveness. J Acquir Immun Defic Syndr 1991; 4: 188–96Google Scholar
  21. 21.
    Iorio AM, Alatri A, Francisci D, et al. Immunogenicity of influenza vaccine (1993-94 winter season) in HIV-seropositive and -seronegative ex-intravenous drug users. Vaccine 1997; 15(1): 97–102PubMedCrossRefGoogle Scholar
  22. 22.
    Schneider MME, Sprenger MJW, Hoepelman IM, et al. Antibody response to tetravalent influenza subunit vaccine in patients infected with human immunodeficiency virus type 1. Int J Antimicrob Agents 1996; 6(4): 195–200PubMedCrossRefGoogle Scholar
  23. 23.
    Huengsberg M, Chakraverty MP, Cooper G, et al. Response to influenza immunization in asymptomatic HIV infected men. Genitourin Med 1995; 71: 355–7PubMedGoogle Scholar
  24. 24.
    Brydak L, Ordyñska E, Wasilewski B, et al. Immunogenicity of trivalent subunit influenza vaccine in elderly people with chronic medical conditions vaccinated in 1993 in Poland. Antiinfect Drugs Chemother 1997; 15(1): 9–12Google Scholar
  25. 25.
    Hirota Y, Kaji M, Ide S, et al. The hemagglutination inhibition antibody responses to an inactivated influenza vaccine among healthy adults: with special reference to the prevaccination antibody and its interaction with age. Vaccine 1996; 14: 1597–602PubMedCrossRefGoogle Scholar
  26. 26.
    Committee for Proprietary Medicinal Products (CPMP). Note for guidance on harmonisation of requirements for influenza vaccines (revision). 1997 Mar 12: CPMP/BWP/214/96Google Scholar
  27. 27.
    Commission of the European Communities. The rules governing medicinal products in the European Community. Commission Eur Commun 1992; 3(2): 93–8Google Scholar

Copyright information

© Adis International Limited 1999

Authors and Affiliations

  • Lidia B. Brydak
    • 1
  • Henryk Jan Hryniewicz
    • 2
  • Magdalena Machala
    • 1
  • Andrzej Horban
    • 3
  1. 1.National Influenza Center WHO, Department of VirologyNational Institute of HygieneWarsawPoland
  2. 2.Liver and AIDS UnitUniversity Medical SchoolWarsawPoland
  3. 3.AIDS Diagnosis and Therapy CenterWarsawPoland

Personalised recommendations