Immunogenicity of Licensed Influenza A (H1N1) 2009 Monovalent Vaccines in HIV-infected Children and Youth

摘要

Background. With the emergence of pandemic influenza A (pH1N1) in 2009, children and youth infected with human immunodeficiency virus (HIV) were vulnerable because of immunologic impairment and the greater virulence of this infection in young persons. Methods. A multicenter study of the immunogenicity of 3 licensed influenza A (H1N1) monovalent vaccines (1 live attenuated and 2 inactivated) was conducted in children and youth with perinatal HIV infection, most of whom were receiving >3 antiretroviral drugs, had CD4% >15, and plasma HIV RNA levels 40. For subjects aged 6 months to 40- and >4-fold rise in HAI titers after the second dose of vaccine. Three weeks after a single immunization with an inactivated vaccine, similar immunogenicity results were achieved in youth aged 10-24 years. With multivariable analysis, only Hispanic ethnicity and CD4% >=15 were associated with achieving both HAI titer >=40- and >=4-fold rise in titer. Conclusions. Although licensed pHlNl vaccines produced HAI titers that were considered to be protective in the majority of HIV-infected children and youth, the proportion with titers >=40- and >=4-fold rise in titer was lower than expected for children without HIV infection. Vaccine immunogenicity was lower in HIV-infected children and youth with evidence of immune suppression.