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Strong serological responses and HIV RNA increase following AS 03‐adjuvanted pandemic immunization in HIV ‐infected patients
Author(s) -
Calmy A,
Bel M,
Nguyen A,
Combescure C,
Delhumeau C,
Meier S,
Yerly S,
Kaiser L,
Hirschel B,
Siegrist CA
Publication year - 2012
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2011.00961.x
Subject(s) - medicine , interquartile range , immunization , vaccination , immunology , viral load , serology , antibody , human immunodeficiency virus (hiv) , virology
We aimed to determine the antibody responses and effect on viral load of the AS 03‐adjuvanted pandemic H1N1 vaccine in HIV ‐infected patients. Method A total of 121 HIV ‐infected patients and 138 healthy subjects were enrolled in a prospective, open‐label study. Healthy subjects received one dose and HIV ‐infected patients two doses of the AS 03‐adjuvanted split influenza A /09/ H1N1 vaccine ( P andemrix®; GlaxoSmithKline , Brentford, United Kingdom.) at an interval of 3–4 weeks. The study was extended in 2010/2011 for 66 patients. Geometric mean titres ( GMT s), seroprotection rates (post‐vaccination titre ≥1:40) and HIV ‐1 RNA levels were measured before and 4 weeks after immunization. Results After two immunizations, the seroprotection rate (94.2 vs. 87%, respectively) and GMT (376 vs. 340, respectively) in HIV ‐infected patients were as high as in healthy subjects after one dose, regardless of CD 4 cell count. Four weeks after immunization, HIV RNA was detected in plasma samples from 40 of 68 (58.0%) previously aviraemic patients [median 152 HIV ‐1 RNA copies/m L ; interquartile range ( IQR ) 87–509 copies/m L ]. Subsequent measures indicated that HIV RNA levels had again declined to <20 copies/m L in most patients (27 of 34; 79.4%). Following (nonadjuvanted) influenza immunization in 2010/2011, HIV RNA levels only slightly increased (median final level 28 copies/m L ) in three of 66 (4.5%) previously aviraemic patients, including two of 25 (8%) patients in whom an increase had been elicited by AS 03‐adjuvanted vaccine the year before. Conclusion Most HIV ‐infected patients developed seroprotection after two doses of AS 03‐adjuvanted pandemic vaccine. A transient effect on HIV RNA levels was observed in previously aviraemic patients. A booster dose of the nonadjuvanted influenza vaccine containing the A/09/ H1N1 strain the following year did not reproduce this finding, indicating a non‐antigen‐specific adjuvant effect.