Responses to pandemic ASO3-adjuvanted A/California/07/09 H1N1 influenza vaccine in human immunodeficiency virus-infected individuals

Abstract

BackgroundInfluenza infection may be more serious in human immunodeficiency virus (HIV)-infected individuals, therefore, vaccination against seasonal and pandemic strains is highly advised. Seasonal influenza vaccines have had no significant negative effects in well controlled HIV infection, but the impact of adjuvanted pandemic A/California/07/2009 H1N1 influenza hemaglutinin (HA) vaccine, which was used for the first time in the Canadian population as an authorized vaccine in autumn 2009, has not been extensively studied.ObjectiveAssess vaccine-related effects on CD4+ T cell counts and humoral responses to the vaccine in individuals attending the Newfoundland and Labrador Provincial HIV clinic.MethodsA single dose of ArepanrixTM split vaccine including 3.75 μg A/California/07/2009 H1N1 HA antigen and ASO3 adjuvant was administered to 81 HIV-infected individuals by intramuscular injection. Plasma samples from shortly before, and 1–5 months after vaccination were collected from 80/81 individuals to assess humoral anti-H1N1 HA responses using a sensitive microbead-based array assay. Data on CD4+ T cell counts, plasma viral load, antiretroviral therapy and patient age were collected from clinical records of 81 individuals.ResultsOverall, 36/80 responded to vaccination either by seroconversion to H1N1 HA or with a clear increase in anti-H1N1 HA antibody levels. Approximately 1/3 (28/80) had pre-existing anti-H1N1 HA antibodies and were more likely to respond to vaccination (22/28). Responders had higher baseline CD4+ T cell counts and responders without pre-existing antibodies against H1N1 HA were younger than either non-responders or responders with pre-existing antibodies. Compared to changes in their CD4+ T cell counts observed over a similar time period one year later, vaccine recipients displayed a minor, transient fall in CD4+ T cell numbers, which was greater amongst responders.ConclusionsWe observed low response rates to the 2009 pandemic influenza vaccine among HIV-infected individuals without pre-existing antibodies against H1N1 HA and a minor transient fall in CD4+ T cell numbers, which was accentuated in responders. A single injection of the ArepanrixTM pandemic A/California/07/2009 H1N1 HA split vaccine may be insufficient to induce protective immunity in HIV-infected individuals without pre-existing anti-H1N1 HA responses.

Adjuvanted influenza a (H1N1) 2009 vaccine in patients with hematological diseases: good safety and immunogenicity even in chemotherapy‐treated patients

“…used adjuvanted influenza vaccine and demonstrated a significant improvement in seroprotection rates after the second vaccine dose . Similar results are reported in human immunodeficiency virus–infected individuals, who also represent a potentially immunocompromised group . In the current study, the second dose of the vaccine improved both immunological responses and seroconversion rates even in heavily chemotherapy‐treated patients.…”

HIV-dependent depletion of influenza-specific memory B cells impacts B cell responsiveness to seasonal influenza immunisation

“…Our results suggest that annual IIV3 vaccination of HIV-infected individuals is important to maintain or re-establish pools of B cell memory. Improved vaccination strategies, such as the incorporation of novel adjuvants 23 59 60 61 , may be required to efficiently repopulate influenza-specific B cell populations in this vulnerable group. Further investigations into the mechanistic basis and clinical consequences of influenza-specific memory B cell depletion in the context of HIV infection should be explored.…”

Antibody Responses with Fc-Mediated Functions after Vaccination of HIV-Infected Subjects with Trivalent Influenza Vaccine

“…poorly to influenza vaccination, particularly if immunodeficient (18,19). To investigate if HIV infection alters ADCC and ADP responses to vaccination, we concurrently recruited cohorts of HIV-infected (n ϭ 27) and HIV-uninfected (n ϭ 30) subjects to receive the 2015 Southern Hemisphere TIV (Fig.…”