Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Prevention and Control, Beijing, China.
Department of Infectious Diseases and Medical Immunology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Vaccine. 2023 Jul 31;41(34):4978-4985. doi: 10.1016/j.vaccine.2023.05.055. Epub 2023 Jun 30.
A limited amount of information is available about the immunogenicity of the quadrivalent inactivated influenza vaccine among human immunodeficiency virus (HIV)-infected individuals, especially in low and middle-income countries (LMICs).
HIV-infected adults and HIV-uninfected adults received a dose of quadrivalent inactivated influenza vaccine including strains of H1N1, H3N2, BV and BY. Enzyme-linked immunosorbent assay (ELISA) and hemagglutination-inhibition assay (HAI) were used to determine IgA, IgG antibody concentration and geometric mean titers (GMT) at day 0 and day 28, respectively. Associated factors contributing to seroconversion or GMT changes were analyzed using simple logistic regression model.
A total of 131 HIV-infected and 55 HIV-uninfected subjects were included in the study. In both HIV-infected and uninfected arms, IgG and IgA against influenza A and B all increased significantly at day 28 after receiving QIV (P < 0.001). GMTs of post-vaccination at day 28 showed that HIV-infected persons with CD4 + T cell counts ≤ 350 cells/mm were statistically less immunogenic to all strains of QIV than HIV-uninfected ones (P < 0.05). HIV-infected participants with CD4 + T cell counts ≤ 350 cells/mm were less likely to achieve seroconversion to QIV (H1N1, BY and BV) than HIV-uninfected individuals at day 28 after vaccination (P < 0.05). Compared with HIV-infected patients with baseline CD4 + T cell counts ≤ 350 cells/mm, individuals with baseline CD4 + T cell counts > 350 cell/mm seemed more likely to generate antibody responses to H1N1 (OR:2.65, 95 %CI: 1.07-6.56) and BY (OR: 3.43, 95 %CI: 1.37-8.63), and showed a higher probability of seroconversion to BY (OR: 3.59, 95 %CI: 1.03-12.48). Compared with nadir CD4 + T cell count ≤ 350 cell/mm, individuals with nadir CD4 + T cell count > 350 cell/mm showed a higher probability of seroconversion to H1N1(OR: 3.15, 95 %CI: 1.14-8.73).
Influenza vaccination of HIV-infected adults might be effective despite variable antibody responses. HIV-positive populations with CD4 + T cell counts ≤ 350 are less likely to achieve seroconversion. Further vaccination strategies could be developed for those with low CD4 T cell counts.
关于感染人类免疫缺陷病毒（HIV）个体中四价灭活流感疫苗的免疫原性，仅有少量信息可用，尤其是在中低收入国家（LMICs）。
HIV 感染者和 HIV 未感染者均接受一剂四价灭活流感疫苗，其中包括 H1N1、H3N2、BV 和 BY 株。酶联免疫吸附试验（ELISA）和血凝抑制试验（HAI）用于分别在第 0 天和第 28 天确定 IgA 和 IgG 抗体浓度和几何平均滴度（GMT）。使用简单逻辑回归模型分析导致血清转化率或 GMT 变化的相关因素。
共纳入 131 名 HIV 感染者和 55 名 HIV 未感染者。在 HIV 感染者和未感染者中，接种 QIV 后第 28 天，流感 A 和 B 的 IgG 和 IgA 均显著增加（P<0.001）。接种后第 28 天的 GMT 显示，与 HIV 未感染者相比，CD4+T 细胞计数≤350 个/mm 的 HIV 感染者对所有 QIV 株的免疫原性均较低（P<0.05）。与接种疫苗后第 28 天未发生血清转化的 HIV 未感染者相比，CD4+T 细胞计数≤350 个/mm 的 HIV 感染者更不可能对 QIV（H1N1、BY 和 BV）发生血清转化（P<0.05）。与基线 CD4+T 细胞计数≤350 个/mm 的 HIV 感染者相比，基线 CD4+T 细胞计数>350 个/mm 的个体似乎更有可能对 H1N1（OR：2.65，95%CI：1.07-6.56）和 BY（OR：3.43，95%CI：1.37-8.63）产生抗体反应，并且更有可能对 BY 发生血清转化（OR：3.59，95%CI：1.03-12.48）。与最低 CD4+T 细胞计数≤350 个/mm 相比，最低 CD4+T 细胞计数>350 个/mm 的个体更有可能对 H1N1 发生血清转化（OR：3.15，95%CI：1.14-8.73）。
尽管抗体反应存在差异，但对 HIV 感染者进行流感疫苗接种可能是有效的。CD4+T 细胞计数≤350 的 HIV 阳性人群不太可能发生血清转化。对于 CD4 细胞计数较低的人群，可以制定进一步的疫苗接种策略。
