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Impact of influenza vaccination (IFV) on HIV plasma RNA and patterns of immune response (ir) in patients (pts) on HAART.

Gunthard H, Wong J, Spina C, Ignacio C, Kwok S, Christopherson C, Wang J, Haubrich R, Havlir D, Richman D; Conference on Retroviruses and Opportunistic Infections.

Program Abstr 6th Conf Retrovir Oppor Infect Conf Retrovir Oppor Infect 6th 1999 Chic Ill. 1999 Jan 31-Feb 4; 6th: 131 (abstract no. 337).

University of California, San Diego.

Objectives: To determine the effect of IFV on HIV replication in pts on HAART with undetectable and low plasma HIV RNA, and to compare IR in HIV+ pts with healthy controls (ctrl). Methods: 21 pts (20 on HAART) with a mean CD4 count of 404 cells/mm3 receiving IFV were prospectively studied. HIV plasma RNA, HIV DNA, and CD4/CD8 T-lymphocyte phenotypes were measured at baseline, and weeks (wk) 1, 2, 4, 6-8. Humoral IR was measured by influenza virus hemagglutination inhibition (HI). 5 ctrls were included in parallel to compare IR. Results: Virology: At baseline, 11 pts [group I] had < 50 RNA c/ml, 5 pts [group II] had 50-400 c/ml and 3 pts [group III] had > 400 c/ml. After IFV, 3/11 pts from group I showed transient elevations of plasma RNA levels: at wk 1 or 2 (RNA 76-89 c/ml). All 5 pts from group II had a RNA rise, which persisted out to wk 8 in 4/5 pts. The 3 pts from group III had a rise in both plasma RNA and HIV DNA. HIV DNA from pts in group I and II revealed little change over time. Immunology: 11/21 pts had a 4-fold rise of HI titers against a flu antigen. Ctrls showed: a) a transient mean CD4 rise of 175 cells/mm3 at wk 2; b) a decline of CD45RA+CD62L+CD4 cells at wk 1+2 (-10%); c) a rise of CD45RO+CD25+CD4 cells at wk 1-2 (+2.8%). The response from the HIV+ pts differed significantly (p < 0.05) from this pattern with: a) only minimal CD4 count rise, b) only small decline in CD45RA+CD62L+CD4 cells (-1.2%), c) a decline in CD45RO+CD25+CD4 cells (-2%). However, the group I pattern of IR was close to that of ctrls. Conclusions: 1) A temporal correlation between IFV and HIV plasma viremia was seen. 2) A transient rise in plasma RNA was seen in only 3/11 group I pts. Whether this represents in vivo stimulation of latently infected cells or upregulation of low level replication remains to be defined. 3) The RNA increase seen in all 5 pts from group II confirms ongoing viral replication in pts with 50-400 plasma RNA c/ml. 4) CD4 cell phenotypic IR in HIV+ pts differed significantly from a characteristic pattern observed in ctrls.

Publication Types:
  • Meeting Abstracts
Keywords:
  • AIDS Vaccines
  • Acquired Immunodeficiency Syndrome
  • Antiretroviral Therapy, Highly Active
  • Blood Transfusion
  • CD4 Lymphocyte Count
  • CD4-Positive T-Lymphocytes
  • CD8-Positive T-Lymphocytes
  • HIV Infections
  • HIV Seropositivity
  • Humans
  • Plasma
  • RNA
  • RNA, Viral
  • RNA, immune
  • Vaccination
  • Viremia
Other ID:
  • 20711578
UI: 102188995

From Meeting Abstracts




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