Sybil A. Tasker, MD; John J. Treanor, MD; William B. Paxton, MD, PhD; Mark R. Wallace, MD
Acknowledgments: The authors thank Rita Rossetti for tireless assistance with patient enrollment and follow-up, Duane Samuelson for vaccine preparation and randomization, Greg Gray and R. Riffenburg for help with statistics, Rosalind Battaglia for performing the hemagglutination inhibition assays, and R. Levandowski for providing the vaccine component antigens for antibody testing.
Requests for Reprints: Clinical Research Department, U.S. Naval Medical Center San Diego, 34800 Bob Wilson Drive, Suite 5, San Diego, CA 92134-1005.
Current Author Addresses: Drs. Tasker and Wallace: Infectious Diseases Division, U.S. Naval Medical Center, San Diego, CA 92134-5000.
Dr. Treanor: University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642.
Dr. Paxton: Agouron Pharmaceuticals, Inc., 11095 Torreyanna Road, San Diego, CA 92121.
Although influenza vaccination is recommended in persons infected with HIV-1, its efficacy is unknown.
To assess the immunogenicity, efficacy, and risks associated with influenza vaccination in persons infected with HIV-1.
Randomized, double-blind, placebo-controlled trial.
Outpatient military clinic.
102 patients with HIV-1 infection.
Influenza vaccine (n = 55) or saline placebo (n = 47).
Influenza antibody titers, CD4+ cell counts, and plasma HIV-1 RNA levels at baseline, 1 month after immunization, and 3 months after immunization; viral cultures from persons presenting with respiratory illness; and respiratory symptom interview.
Twenty-three placebo recipients (49%) and 16 vaccine recipients (29%) reported respiratory symptoms (P = 0.04). Ten placebo recipients but no vaccine recipients had laboratory-confirmed symptomatic influenza (P < 0.001) (protective efficacy, 100% [95% CI, 73% to 100%]). No effect on plasma HIV-1 RNA levels or CD4+ cell counts was noted.
Influenza vaccination is highly effective in HIV-1-infected persons and does not seem to be associated with substantial changes in viral load or CD4 cell count.
Table 1. Baseline Characteristics of the Study Sample
Table 2. Antibody Response to Influenza Vaccination
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Tasker SA, Treanor JJ, Paxton WB, Wallace MR. Efficacy of Influenza Vaccination in HIV-Infected Persons: A Randomized, Double-Blind, Placebo-Controlled Trial. Ann Intern Med. 1999;131:430–433. doi: 10.7326/0003-4819-131-6-199909210-00006
Download citation file:
Published: Ann Intern Med. 1999;131(6):430-433.
Infectious Disease, Influenza, Prevention/Screening, Vaccines/Immunization.
Copyright © 2019 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use