Wroclaw Medical University, Department of Pediatric Infectious Diseases.
Wroclaw University of Environmental and Life Sciences, Department of Pathology, Division of Microbiology.
Przegl Epidemiol. 2020;74(4):667-675. doi: 10.32394/pe.74.58.
Pediatric patients infected with the human immunodeficiency virus (HIV) are at risk of developing severe influenza. Vaccination against influenza in HIV (+) children in Poland is recommended and free of charge. The aim of the study was to evaluate the effectiveness of influenza vaccination in this group of patients.
The study group consisted of 25 HIV-infected children, patients of the Department of Paediatric Infectious Diseases in Wrocław, vaccinated against influenza from September to December 2016. The incidence of influenza and influenza-like diseases was monitored from December 1, 2016 to April 15, 2017. IgG / IgM against influenza A and B by ELISA and against AH1N1 by HI method before vaccination and 4-6 weeks after vaccination were determined. Nasopharyngeal swabs of influenza RNA for PCR testing were collected in each patient during each hospitalization in the epidemic season.
In the 2016/2017 epidemic season, none of the patients developed symptomatic influenza or any other flu-like infection with fever. Influenza A virus RNA was detected in nasopharyngeal swabs in 8 patients, none of them presented any clinical symptoms of infection. Positive pre-vaccination IgG levels against influenza A and B were detected in 36% (9/25) and 68% (17/25) of patients, respectively. After vaccination, positive concentrations were found in 56% (14/25) and 80% (20/25) of patients, respectively. Positive concentration of IgM antibodies was achieved by 60% (15/25) of the respondents - for influenza A and 52% (13/25) - for influenza B. In 11 patients (45.8%) before vaccination, protective titres of antibodies against H1 haemagglutinin were obtained, after the vaccination the proportion of patients with a protective titer was 52.4%.
Influenza vaccination in HIV-infected children is effective in preventing symptomatic influenza virus infection but does not prevent transmission of infection in the population. Annual influenza vaccination and seasonal natural infections with influenza viruses result in the persistence of measurable antibody levels until the next epidemic season.
感染人类免疫缺陷病毒（HIV）的儿科患者有发生严重流感的风险。波兰建议对 HIV（+）儿童进行流感疫苗接种，且免费。本研究旨在评估该组患者流感疫苗接种的效果。
研究组包括 25 名在弗罗茨瓦夫儿科传染病科接种流感疫苗的 HIV 感染儿童，接种时间为 2016 年 9 月至 12 月。从 2016 年 12 月 1 日至 2017 年 4 月 15 日，监测流感和流感样疾病的发病率。在接种疫苗前和接种疫苗后 4-6 周，通过 ELISA 测定针对流感 A 和 B 的 IgG/IgM，通过 HI 法测定针对 AH1N1 的 IgG/IgM。在流行季节的每次住院期间，每位患者都采集鼻咽拭子进行 PCR 检测流感 RNA。
在 2016/2017 流行季节，没有患者出现有症状的流感或任何其他发热的流感样感染。在 8 名患者的鼻咽拭子中检测到甲型流感病毒 RNA，但他们均无任何感染的临床症状。接种前，分别有 36%（9/25）和 68%（17/25）的患者对流感 A 和 B 有阳性的 IgG 水平。接种后，分别有 56%（14/25）和 80%（20/25）的患者呈阳性浓度。分别有 60%（15/25）和 52%（13/25）的患者的 IgM 抗体呈阳性浓度。在接种前，有 11 名患者（45.8%）获得了针对 H1 血凝素的保护性抗体滴度，接种后，有保护性滴度的患者比例为 52.4%。
在 HIV 感染儿童中进行流感疫苗接种可有效预防有症状的流感病毒感染，但不能预防人群中感染的传播。每年进行流感疫苗接种和季节性流感病毒自然感染会导致下一个流行季节前抗体水平持续可测量。
