Higher Memory Responses in HIV-Infected and Kidney Transplanted Patients than in Healthy Subjects following Priming with the Pandemic Vaccine

Abstract

BackgroundMemory responses require immune competence. We assessed the influence of priming with AS03-adjuvanted pandemic vaccine (Pandemrix®) on memory responses of HIV patients, kidney recipients (SOT) and healthy controls (HC).MethodParticipants (HIV: 197, SOT: 53; HC: 156) were enrolled in a prospective study and 390/406 (96%) completed it. All had been primed in 2009/2010 with 1 (HC) or 2 (patients) doses of Pandemrix®, and were boosted with the 2010/2011 seasonal influenza vaccine. Geometric mean titres and seroprotection rates were measured 12 months after priming and 4 weeks after boosting. Primary and memory responses were directly compared in 191 participants (HCW: 69, HIV: 71, SOT: 51) followed during 2 consecutive seasons.ResultsMost participants (HC: 77.8%, HIV: 77.6%, SOT: 66%) remained seroprotected at 12 months post-priming. Persisting A/09/H1N1 titers were high in HIV (100.2) and HC (120.1), but lower in SOT (61.4) patients. Memory responses reached higher titers in HIV (507.8) than in HC (253.5) and SOT (136.9) patients. Increasing age and lack of HAART reduced persisting and memory responses, mainly influenced by residual antibody titers. Comparing 2009/2010 and 2010/2011 titers in 191 participants followed for 2 seasons indicated lower post-2010/2011 titers in HC (240.2 vs 313.9), but higher titers in HIV (435.7 vs 338.0) and SOT (136 vs 90.3) patients.ConclusionsPriming with 2 doses of Pandemrix® elicited persistent antibody responses and even stronger memory responses to non-adjuvanted seasonal vaccine in HIV patients than 1 dose in healthy subjects. Adjuvanted influenza vaccines may improve memory responses of immunocompromised patients.Trial RegistrationClinicalTrials.gov NCT01022905

Key differences in B cell activation patterns and immune correlates among treated HIV-infected patients versus healthy controls following influenza vaccination

“…Although some studies demonstrated that HIV+ patients have similar or greater responses to the influenza vaccine [31,38,39], most reported that these patients have compromised responses to this vaccine [5,17-19,22,40], in disagreement with our results. Potential reasons for this discrepancy may include differences in patient populations.…”

“…CD4+ T cells, especially T follicular helper (Tfh) cells, B cells, innate immunity, sex, age, and the magnitude of viral replication have been shown to correlate with responses to influenza vaccination in HIV-infected patients [5,8,10,12-14,17,20-30]. In contrast, a study conducted by Siegrist et al has shown that HIV-infected patients have higher memory responses following pandemic influenza vaccination [31]. It is clear that the influenza vaccine response is impaired in antiretroviral therapy (ART)-naïve and viremic patients [5,20].…”

Humoral, T-cell and B-cell immune responses to seasonal influenza vaccine in solid organ transplant recipients receiving anti-T cell therapies

“…It is unclear why the SOT recipients elicited a weak baseline MBC response, but previous studies identified the use of MPA as a responsible for a reduced HLA-DR expression on B cells after influenza vaccination [41]. Defective MBC responses were not observed in other studies including stable kidney transplant recipients [42] and HIV-infected children vaccinated against influenza [43].…”

Antibody persistence 1 year after pandemic H1N1 2009 influenza vaccination and immunogenicity of subsequent seasonal influenza vaccine among adult organ transplant patients

“…Recently, two studies have been published on the loss of the antibody protection 1 year after using A(H1N1)pdm09 vaccine in SOT recipients . Cordero et al .…”

“…Siegrist et al . used two doses of AS03‐adjuvanted influenza vaccine – as in our study. They found that 67% of the kidney transplant recipients had protective titres 1 month after immunization.…”