The Influence of Human Immunodeficiency Virus (HIV) Infection on Antibody Responses to Influenza Vaccines

Ke, Nelson; Ml, Clements; Miotti, Paolo; Cohn, Sylvia; Bf, Polk

doi:10.7326/0003-4819-109-5-383

Cited by 114 publications

(27 citation statements)

References 17 publications

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“…Among them, lack of awareness, poor acceptance by physicians and/or patients, ease of access, cost and safety profile of the various preventive measures could play a significant role in this respect. Of note, it has been demonstrated that effectiveness of these interventions may decrease with time or as HIV disease progresses [5,14,18]. Whatever the mechanism leading to the suboptimal use of the specific preventive therapies under study, the present data suggest that this can be partially reversed with the use of targeted feedback.…”

Section: Discussionmentioning

confidence: 58%

“…It should be stressed that despite multiple publications supporting the use of current guidelines, the supportive evidence is not uniform [5,14,[20][21][22][23][24][25][26]. In contrast to the unequivocal evidence in favour of primary and secondary PCP prophylaxis [8][9][10], the usefulness of repeated PPD skin testing, influenza and pneumococcal vaccination has been less thoroughly documented [11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to the unequivocal evidence in favour of primary and secondary PCP prophylaxis [8][9][10], the usefulness of repeated PPD skin testing, influenza and pneumococcal vaccination has been less thoroughly documented [11][12][13][14][15]. Furthermore, a number of studies have identified limitations of the latter interventions within specific subgroups of HIV-infected patients.…”

Section: Discussionmentioning

confidence: 99%

“…The safety and efficacy of primary and secondary PCP prophylaxis have been firmly established [8][9][10]. On the other hand, the clinical usefulness of PPD skin testing, influenza and pneumococcal vaccination in patients with HIV disease appears to vary, depending on a number of factors, such as the prevalence of tuberculosis or degree of immunodeficiency [11][12][13][14][15].…”

mentioning

confidence: 99%

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Adherence to guidelines for the prevention of HIV-related respiratory diseases

Montaner¹,

Phillips²,

Zala³

et al. 1996

Eur Respir J

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A Ad dh he er re en nc ce e t to o g gu ui id de el li in ne es s f fo or r t th he e p pr re ev ve en nt ti io on n o of f H HI IV V--r re el la at te ed d r re es sp pi ir ra a--t to or ry y d di is se ea as se es s ABSTRACT: In this study we characterized the pattern of use of preventive therapies for specific respiratory diseases within a cohort of homosexual men and assessed the impact of targeted feedback on the level of compliance with guidelines for these diseases. All human immunodeficiency virus seronegative (HIV-) (n=169) and acquired immune deficiency syndrome (AIDS)-free human immunodeficiency virus seropositive (HIV+) (n=154) participants in our cohort, who completed four annual visits between October 1989 and December 1993, were identified. Information about the use of purified protein derivative (PPD) (tuberculin) testing, history of pneumococcal vaccinations, influenza vaccinations, use of Pneumocystis carinii pneumonia (PCP) prophylaxis, symptoms and CD4 counts was obtained yearly for each subject. In 1992, participating physicians were provided with feedback regarding the overall levels of compliance with contemporary guidelines for the prevention of respiratory disease. As part of this exercise, the guidelines were distributed and discussed.The percentage of HIV+ patients who underwent PPD testing increased from 43 to 65% during the study (p=0.001). Significantly more HIV+ than HIV-patients underwent PPD testing (p<0.001). A total of 144 (94%) HIV+ men received at least one influenza vaccination compared to 60 (35%) HIV-men (p<0.001). Utilization of influenza vaccination in the HIV+ group significantly increased from 78% in 1992 to 92% in 1993 (p<0.001). A total of 104 (68%) HIV+ men received pneumococcal vaccination compared to 2 (1%) HIV-men (p<0.001). Among HIV+ individuals whose absolute CD4+ count was less than 200 cells·mm -3 , the percentage of men who received primary PCP prophylaxis was 0, 86, 72 and 88 for the years 1990-1993, respectively. Among HIV+ patients whose only eligibility criterion for PCP prophylaxis was a CD4+ percentage <20%, compliance was 55, 30, 37 and 50% for the years 1990-1993, respectively. Among HIV+ subjects, increases in the compliance level were noted for all preventive therapies after targeted feedback was provided during the last quarter of 1992. However, only utilization of influenza vaccine exceeded a 90% compliance in 1993.These data demonstrate that a suboptimal level of compliance with current guidelines for the prevention of respiratory disease among human immunodeficiency virus-infected individuals can be significantly improved using targeted feedback. Although it is likely that similar effects could be achieved in other populations or the community at large, this remains to be demonstrated.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Adherence to guidelines for the prevention of HIV-related respiratory diseases

Montaner¹,

Phillips²,

Zala³

et al. 1996

Eur Respir J

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“…we suggest consideration of other methods of influenza prevention [3,26,27] to avoid potential progression of HIV disease.…”

mentioning

confidence: 99%

Dynamics of HIV-1 replication following influenza vaccination of HIV+ individuals

Røsok¹,

Voltersvik²,

Bjerknes³

et al. 1996

Clinical and Experimental Immunology

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Levels of HIV‐1 have been reported to increase in peripheral blood after influenza vaccination of HIV+ individuals. In this study we have evaluated the dynamics of these changes. Ten HIV‐1+ individuals classified in revised CDC clinical categories B and C as well as five seronegative healthy controls were vaccinated with the recommended influenza strains. HIV viral RNA and proviral DNA were sequentially quantified in serum and blood lymphocytes, respectively. Nine of the 10 HIV+ individuals had an increase in the frequency of infected CD4 cells 2 weeks after influenza vaccination. Individuals with low viral load had a rapid increase in viraemia and a small increase in frequency of infected cells in peripheral blood. In contrast, individuals with high viral load had a small drop in viraemia followed by a significant rise in the rate of infected cells. The observed changes may resemble those taking place during intercurrent infections in HIV+ individuals. The effects of the relative increases in infectious virus after the transient viraemic phase should be further investigated to evaluate potential risks of vaccination.

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Excess Mortality Due to Pneumonia or Influenza During Influenza Seasons Among Persons With Acquired Immunodeficiency Syndrome

Lin¹,

Nichol²

2001

Arch Intern Med

179

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The Influence of Human Immunodeficiency Virus (HIV) Infection on Antibody Responses to Influenza Vaccines

Abstract: Because of the poor antibody responses to influenza vaccines among HIV-infected subjects, even in many with no or minimal symptoms, alternative strategies for preventing influenza, such as booster doses of influenza vaccine, prophylaxis with amantidine, or both should be considered.

Cited by 114 publications

References 17 publications

Adherence to guidelines for the prevention of HIV-related respiratory diseases

Adherence to guidelines for the prevention of HIV-related respiratory diseases

Dynamics of HIV-1 replication following influenza vaccination of HIV+ individuals

Excess Mortality Due to Pneumonia or Influenza During Influenza Seasons Among Persons With Acquired Immunodeficiency Syndrome

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