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J Pediatric Infect Dis Soc. 2013 Dec;2(4):352-60. doi: 10.1093/jpids/pit040. Epub 2013 Jul 17.

Immunogenicity of Licensed Influenza A (H1N1) 2009 Monovalent Vaccines in HIV-Infected Children and Youth.

Author information

1
University of Alabama at Birmingham rpass@peds.uab.edu.
2
SUNY Health Science Center at Stony Brook, New York.
3
St Jude's Children's Research Hospital, Memphis, Tennessee.
4
Statistical and Data Analysis Center, Harvard School of Public Health, Boston, Massachusetts.
5
Duke University Medical Center, Durham, North Carolina.
6
NYU Medical Center, New York, New York.
7
Rush Medical Center, Chicago, Illinois.
8
University of California San Diego, La Jolla Rady Children's Hospital, San Diego, California.
9
Social and Scientific Systems, Silver Spring.
10
Pediatric Adolescent and Maternal AIDS Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda.
11
Division of AIDS, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland.
12
University of Colorado Denver, Aurora.

Abstract

BACKGROUND:

With the emergence of pandemic influenza A (pH1N1) in 2009, children and youth infected with human immunodeficiency virus (HIV) were vulnerable because of immunologic impairment and the greater virulence of this infection in young persons.

METHODS:

A multicenter study of the immunogenicity of 3 licensed influenza A (H1N1) monovalent vaccines (1 live attenuated and 2 inactivated) was conducted in children and youth with perinatal HIV infection, most of whom were receiving ≥3 antiretroviral drugs, had CD4% ≥15, and plasma HIV RNA levels <400 copies/mL. Serum hemagglutinin inhibition assay (HAI) antibody levels were measured and correlated with baseline demographic and clinical variables.

RESULTS:

One hundred forty-nine subjects were enrolled at 26 sites in the United States and Puerto Rico. Over 40% had baseline HAI titers ≥40. For subjects aged 6 months to <10 years, 79% and 68%, respectively, achieved a ≥40- and ≥4-fold rise in HAI titers after the second dose of vaccine. Three weeks after a single immunization with an inactivated vaccine, similar immunogenicity results were achieved in youth aged 10-24 years. With multivariable analysis, only Hispanic ethnicity and CD4% ≥15 were associated with achieving both HAI titer ≥40- and ≥4-fold rise in titer.

CONCLUSIONS:

Although licensed pH1N1 vaccines produced HAI titers that were considered to be protective in the majority of HIV-infected children and youth, the proportion with titers ≥40- and ≥4-fold rise in titer was lower than expected for children without HIV infection. Vaccine immunogenicity was lower in HIV-infected children and youth with evidence of immune suppression.

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