ANTIBODY-RESPONSE TO TETRAVALENT INFLUENZA SUBUNIT VACCINE IN PATIENTS INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1

The capacity of patients infected with human immunodeficiency virus (H IV) to develop an adequate antibody response to influenza Vaccination in relation to the CD4 cell count has been studied in a prospective st udy. A total of 73 subjects (54 HIV-infected patients and 19 healthy c ontrol persons) were vaccinated with influenza subunit vaccine contain ing 15 mu g hemagglutinin of each of the following strains: A/Beijing/ 353/89(H3N2), A/Singapore/6/86(H1N1), B/Panama/45/90, and B/Beijing/1/ 87. Hemagglutinin inhibition (HI) antibody titers were determined prio r to vaccination, 3 weeks afterwards, and at the end of the influenza season. The percentage of subjects with HI antibody titers above the a ssumed protective level was significantly lower in the HIV-infected pa tients for all 4 vaccine strains compared with those in the control gr oup (7-26% and 42-74%, respectively). There was an association between CD4 cell count and antibody response to the B/Panama strain only. The serologic response to tetravalent subunit influenza vaccine is severe ly impaired in the majority of HIV-infected patients compared with con trol subjects. The results of this study challenges the recommendation to vaccinate HN-infected patients.