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The impact of influenza immunization on HIV-1 plasma RNA levels.


Int Conf AIDS. 1996 Jul 7-12;11(2):17 (abstract no. We.B.111). Unique

Objective: To measure HIV-1 plasma RNA (pRNA) levels following influenza vaccination. Methods: HIV-infected patients being offered annual influenza vaccination (trivalent, types A and B subvirion antigens, Wyeth-Ayerst Laboratories) were enrolled in a study to evaluate the effect of vaccination on pRNA. pRNA levels were drawn at baseline and at subsequent routine visits for 12 weeks (grouped into 2, 4, 8 and 12 week intervals), processed and frozen within hours of collection, then batch-tested using a branched DNA assay with a sensitivity of 10,000 copies/mm3 Chiron Corporation). 52/68 enrollees (48 vaccinees and 4 controls) had evaluable specimens at baseline and at least one follow-up visit: 41 (79%) were male and 11 (21%) were female; the mean age was 41 (range 22-63) and the mean value of the most recently drawn CD4 count was 160 (range 0-670); risk factors included hetero IDU (46%), gay/bisexual men (29%), gay/bi IDU 4%), and heterosexual contact (21%). 39/53 had detectable pRNA at baseline, with a mean of 4.97 log (range 4.14-6.2 log) and mean copy number/mm3 of 198,923 (range 13,670 to 1,600,000). table: see text) Results: Among 33 subjects with 2-week follow-up data (see Figure), only 1 vaccinee had a pRNA increase of 0.48 log (3-fold) or more (considered a significant change with this assay). The mean change at 2 weeks for 24/33 with detectable pRNA at baseline was 0.014 log (1.014-fold) among 21 vaccinees and -0.15 log (-1.17-fold) among 3 controls (p=0.34 by Wilcoxon Rank Sum). When stratified by CD4 count/mm3 (0-100, 101-300, 301+), the mean change for each stratum was 0, -0.02 log 1.02-fold), respectively. A subset analysis of 12/52 patients with all 5 data points also showed no trend toward increase in pRNA (not shown). Although in 52 evaluable subjects baseline pRNA was inversely correlated with CD4 count, no relationship between baseline pRNA or CD4 count and subsequent change in pRNA was seen. The relationship between pRNA change and antibody response is currently being analyzed. Conclusion: Our data do not demonstrate an elevation of HIV-1 pRNA levels following influenza vaccination. Further studies are needed to better characterize the potential benefits and risks of routinely vaccinating this population with various immunogens.

*CD4 Lymphocyte Count *HIV Infections/IMMUNOLOGY *Influenza Vaccine/IMMUNOLOGY *RNA, Viral/BLOOD *Vaccination


Information in this article was accurate in January 30, 1997. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.