Details:

Alternative Title:
Clin Infect Dis
Personal Author:
Garg, Shikha ; Thongcharoen, Prasert ; Praphasiri, Prabda ; Chitwarakorn, Anupong ; Sathirapanya, Pornchai ; ... More +
Garg, Shikha ; Thongcharoen, Prasert ; Praphasiri, Prabda ; Chitwarakorn, Anupong ; Sathirapanya, Pornchai ; Fernandez, Stefan ; Rungrojcharoenkit, Kamonthip ; Chonwattana, Wannee ; Mock, Philip A. ; Sukwicha, Wichuda ; Katz, Jacqueline M. ; Widdowson, Marc-Alain ; Curlin, Marcel E. ; Gibbons, Robert V. ; Holtz, Timothy H. ; Dawood, Fatimah S. ; Olsen, Sonja J. Less -
Description:
Background

Individuals infected with human immunodeficiency virus (HIV) are at increased risk for severe influenza, yet immune responses to standard-dose intramuscular (IM) influenza vaccine are suboptimal in this population. Intradermal (ID) delivery of influenza vaccine might improve immune response through enhanced stimulation of dendritic cells.

Methods

We conducted a randomized, double-blind, controlled trial to compare the immunogenicity of off-label standard-dose (15 µg) ID vs standard-dose (15 µg) IM inactive influenza vaccine in HIV-infected men in Bangkok, Thailand. The primary study outcome was seroconversion (minimum titer of 1:40 and ≥4-fold rise in antibody titer) at 1 month postvaccination based on serum hemagglutination inhibition antibody titers against each vaccine strain. Adverse events (AEs) in the 7 days following vaccination were also assessed.

Results

We enrolled 400 HIV-infected participants; 200 were randomly assigned to receive IM and 200 ID vaccine. Vaccine arms were well-balanced with respect to age, CD4 cell count, HIV RNA load, and antiretroviral treatment. Percentage of seroconversion to all (ID 14% vs IM 15%; P = .8) or at least 1 (ID 69% vs IM 68%; P = .7) of the 3 vaccine strains did not differ significantly between ID vs IM vaccine recipients. A higher proportion of participants who received ID vaccine had mild injection-site AEs compared with participants who received IM vaccine (77% vs 27%).

Conclusions

There were no significant differences in the immunogenicity of standard-dose ID vs IM influenza vaccine in this HIV-infected population in Thailand. Additional strategies to enhance immune responses to influenza vaccine among HIV-infected persons are needed.


Subject:
[+]
Adolescent
Adult
Antibodies, Viral
Double-Blind Method
Drug-Related Side Effects And Adverse Reactions
Hemagglutination Inhibition Tests
HIV Infections
Homosexuality, Male
Humans
Influenza, Human
Influenza Vaccines
Injections, Intradermal
Injections, Intramuscular
Male
Middle Aged
Treatment Outcome
Vaccines, Inactivated
Young Adult

Source:
Clin Infect Dis. 62(3):383-391.
Pubmed ID:
26486702
Pubmed Central ID:
PMC4707082
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States ; U01 GH000152/GH/CGH CDC HHS/United States ; 5U01GH000152/GH/CGH CDC HHS/United States
CC999999/Intramural CDC HHS/United States ; U01 GH000152/GH/CGH CDC HHS/United States ; 5U01GH000152/GH/CGH CDC HHS/United States Less -
Place as Subject:
Thailand
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:a94b1eb289582f637d2ad1955a92cc94b099af09d9307b1e08e750f11d5f3e3d
File Type:

Supporting Files

• 	NIHMS740572-supplement-Supplemental_data.docx	docx
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