Anti-Influenza Serum and Mucosal Antibody Responses After Administration of Live Attenuated or Inactivated Influenza Vaccines to HIV-Infected Children

作者：Adriana Weinberg, Lin‐Ye Song, Robert Walker, Maria C. Allende, Terence Fenton, Julie Patterson‐Bartlett, Sharon Nachman, George Kemble, Tingting Yi, Patricia Defechereux, Diane W. Wara, Jennifer S. Read, Myron J. Levin · 发表于：JAIDS Journal of Acquired Immune Deficiency Syndromes · 年份：2010 · DOI：10.1097/qai.0b013e3181e46308 · 被引用次数：43 · 研究领域：Influenza Virus Research Studies、Respiratory viral infections research、HIV Research and Treatment

BACKGROUND: Live-attenuated influenza vaccine (LAIV) prevents more cases of influenza in immune-competent children than the trivalent inactivated vaccine (TIV). We compared the antibody responses to LAIV or TIV in HIV-infected children. METHODS: Blood and saliva obtained at enrollment, 4 and 24 weeks postimmunization from 243 HIV-infected children randomly assigned to TIV or LAIV were analyzed. RESULTS: Both vaccines increased the anti-influenza neutralizing antibodies at 4 and 24 weeks postimmunization. At 4 weeks postimmunization, TIV recipients had 2-fold to 3-fold higher neutralizing antibody titers than LAIV recipients, but the proportions of subjects with protective titers (≥ 1:40) were similar between treatment groups (96%-100% for influenza A and 81%-88% for influenza B). Both vaccines increased salivary homotypic IgG antibodies, but not IgA antibodies. Both vaccines also increased serum heterosubtypic antibodies. Among HIV-specific characteristics, the baseline viral load correlated best with the antibody responses to either vaccine. We used LAIV-virus shedding as a surrogate of influenza infection. Influenza-specific humoral and mucosal antibody levels were significantly higher in nonshedders than in shedders. CONCLUSIONS: LAIV and TIV generated homotypic and heterosubtypic humoral and mucosal antibody responses in HIV-infected children. High titers of humoral or mucosal antibodies correlated with protection against viral shedding.