Safety,immunogenicity and shedding of LAIV4 in HIV-infected and uninfected children |
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| Institution: | 1. University of Colorado Denver, 12700 E 19th Avenue, Room 11126, Aurora, CO 80045, USA;2. Children''s Hospital Colorado, 13123 E 16th Avenue, B055, Aurora, CO 80045, USA;1. Department of Computer Science and Information Engineering, National Yunlin University of Science & Technology, No. 123 University Road, Section 3, Douliou, Yunlin 64002, Taiwan, ROC;2. Graduate School of Engineering Science and Technology Doctoral Program, National Yunlin University of Science & Technology, Taiwan, ROC;3. Department of Information Management, Tainan University of Technology, No. 529, Zhongzheng Rd., Yongkang District, Tainan City 71002, Taiwan, ROC;1. Infectious Disease Unit, Shaare Zedek Medical Center, Affiliated with the Hebrew University Hadassah Medical School, Jerusalem, Israel;2. Clinical Microbiology Laboratory, Shaare Zedek Medical Center, Affiliated with the Hebrew University Hadassah Medical School, Jerusalem, Israel;3. Hebrew University Hadassah Medical School, Jerusalem, Israel;4. Division of Internal Medicine, Shaare Zedek Medical Center, Affiliated with the Hebrew University Hadassah Medical School, Jerusalem, Israel;1. School of Informatics, Linyi University, Linyi, Shandong, 276005, P.R. China;2. School of Information, Qilu University of Technology, Jinan, Shandong, 250353, China;3. School of Information Science and Engineering, Universityof Jinan, Jinan, Shandong, 250022, China;4. Provincial Key Laboratory for Network Based Intelligent Computing, University of Jinan, Jinan, 250022, P.R. China;1. Cardiovascular and Metabolic Disease Department, CHU de Toulouse, Toulouse, France;2. INSERM U1046, Heart and Muscle Pathophysiology and Experimental Medicine, Metabolic Exploration Unit (CERAMM), Service Central de Physiologie Clinique, Hôpital Lapeyronie, CHU de Montpellier, France;3. Department of Epidemiology, Health Economics and Public Health, UMR1027 INSERM-University of Toulouse 3, CHU de Toulouse, Toulouse, France;4. Bariatric Surgery Department, CHU de Toulouse, Toulouse, France |
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| Abstract: | ObjectivesHIV-infected children have poor responses to inactivated influenza vaccines. Live vaccines (LAIVs) are highly efficacious in children, but they are not used in HIV-infected children du e to limited information. We investigated the safety, immunogenicity and viral shedding of LAIV4 in HIV-infected compared with uninfected children.DesignForty-six HIV-infected and 56 uninfected children 2 to 25 years old, who had been previously vaccinated against influenza, consented to receive a single dose of LAIV4. All grade adverse events (AEs) were recorded in the first month post-vaccination and serious AEs (SAEs) throughout the influenza season. Nasopharyngeal swabs for influenza PCR and IgA ELISA and blood for hemagglutination inhibition antibody (HAI) measurements were collected at entry, 2–5, 7–10 and 21–28 days post-vaccination.ResultsThe HIV-infected subjects had median CD4+ cells of 649 cells/μL and plasma HIV RNA of 20 copies/mL. AEs were similar in the two groups. There were no vaccine-related SAEs. Shedding of ≥1 vaccine virus was detected in 67% HIV-infected and 50% uninfected participants (p = 0.14). HAI titers did not appreciably change, but mucosal IgA antibodies significantly increased post-vaccination in both groups. High baseline HAI and IgA antibody concentrations were associated with decreased viral shedding in controls, but not in HIV-infected subjects. Similar proportions of HIV-infected vaccinees and controls reported influenza-like illnesses (12% and 6%) throughout the season.ConclusionsLAIV4 was equally safe and immunogenic and caused similar viral shedding in HIV-infected and uninfected children. A correlate of protection against vaccine viral shedding was not identified in HIV-infected participants, although both circulating and mucosal antibodies correlated with protection in controls. |
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| Keywords: | LAIV4 Safety Immunogenicity HIV Children Influenza vaccine Influenza infection |
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