Abstract
Background. Individuals infected with human immunodeficiency virus (HIV) are at increased risk for severe influenza, yet immune responses to standard-dose intramuscular (IM) influenza vaccine are suboptimal in this population. Intradermal (ID) delivery of influenza vaccine might improve immune response through enhanced stimulation of dendritic cells. Methods. We conducted a randomized, double-blind, controlled trial to compare the immunogenicity of off-label standard-dose (15 μg) ID vs standard-dose (15 μg) IM inactive influenza vaccine in HIV-infected men in Bangkok, Thailand. The primary study outcome was seroconversion (minimum titer of 1:40 and ≥4-fold rise in antibody titer) at 1 month postvaccination based on serum hemagglutination inhibition antibody titers against each vaccine strain. Adverse events (AEs) in the 7 days following vaccination were also assessed. Results. We enrolled 400 HIV-infected participants; 200 were randomly assigned to receive IM and 200 ID vaccine. Vaccine arms were well-balanced with respect to age, CD4 cell count, HIV RNA load, and antiretroviral treatment. Percentage of seroconversion to all (ID 14% vs IM 15%; P =. 8) or at least 1 (ID 69% vs IM 68%; P =. 7) of the 3 vaccine strains did not differ significantly between ID vs IM vaccine recipients. A higher proportion of participants who received ID vaccine had mild injection-site AEs compared with participants who received IM vaccine (77% vs 27%). Conclusions. There were no significant differences in the immunogenicity of standard-dose ID vs IM influenza vaccine in this HIV-infected population in Thailand. Additional strategies to enhance immune responses to influenza vaccine among HIV-infected persons are needed.
Original language | English (US) |
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Pages (from-to) | 383-391 |
Number of pages | 9 |
Journal | Clinical Infectious Diseases |
Volume | 62 |
Issue number | 3 |
DOIs | |
State | Published - Feb 1 2016 |
Externally published | Yes |
Keywords
- HIV
- immunogenicity
- influenza
- intradermal
- vaccine
ASJC Scopus subject areas
- Microbiology (medical)
- Infectious Diseases