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首页> 外文期刊>HIV medicine >Improved serological response to H1N1 monovalent vaccine associated with viral suppression among HIV-1-infected patients during the 2009 influenza (H1N1) pandemic in the Southern Hemisphere
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Improved serological response to H1N1 monovalent vaccine associated with viral suppression among HIV-1-infected patients during the 2009 influenza (H1N1) pandemic in the Southern Hemisphere

机译：在南半球2009年流感（H1N1）大流行期间，HIV-1感染患者对H1N1单价疫苗的血清学反应得到改善，并伴有病毒抑制

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Objectives: Patients infected with HIV-1 were targeted for vaccination against H1N1 influenza because of their anticipated increased risk of mortality associated with H1N1 infection. Reports regarding the efficacy of vaccination in HIV-1-infected patients have suggested a reduced immunogenic response compared with the general population. Hence, the study aimed to determine the serological response to pandemic H1N1 influenza vaccine in HIV-1-infected patients in a clinical setting. Methods: A retrospective review of all HIV-1-infected patients who attended mass H1N1 vaccination between October 2009 and March 2010 at an Australian HIV clinic was carried out. Pre- and post-vaccination H1N1 antibody titres were measured. The main outcome measure was response to the vaccination, which was defined as an H1N1 antibody titre of ≥1:40 using a haemagglutination inhibition (HI) assay. Results: Baseline blood samples were collected from 199 patients, of whom 154 agreed to receive vaccination; of these, 126 had pre- and post-vaccination HI titres measured. Seventy-seven of 199 patients (38.7%) showed a baseline antibody titre of ≥1:40. Eighty-five (67.4%) showed a fourfold or greater increase in titre and 109 of 126 (86.5%) achieved an antibody titre of ≥1:40 after vaccination. The serum HI H1N1 antibody geometric mean titre (GMT) for the 126 paired samples was 39.32±3.46 pre-vaccination and increased to 237.36±3.94 [standard deviation (SD)] post-vaccination (P<0.001). In a binary logistic regression analysis, HIV viral load and baseline HI antibody titre were significantly associated with post-vaccination increase in HI H1N1 antibody titre. Conclusions: A high prevalence of HI H1N1 antibodies was found before vaccination in the cohort, consistent with previous exposure to H1N1 influenza virus. The response to vaccination was considered adequate, as more than two-thirds of patients achieved a fourfold or more increase in antibody titre after vaccination. The response to vaccination was significantly greater in those patients who were aviraemic for HIV, suggesting that antiretroviral therapy improves the humoral response, which is important in optimizing vaccine effectiveness.
机译：目的：感染HIV-1的患者被靶向接种H1N1流感疫苗，因为他们预期与H1N1感染相关的死亡风险会增加。关于在HIV-1感染患者中接种疫苗的功效的报告表明，与普通人群相比，免疫原性应答降低。因此，该研究旨在确定临床环境中HIV-1感染患者对大流行H1N1流感疫苗的血清学反应。方法：对2009年10月至2010年3月在澳大利亚HIV诊所接受大规模H1N1疫苗接种的所有HIV-1感染患者进行了回顾性研究。测量了疫苗接种前后的H1N1抗体滴度。主要结果指标是对疫苗接种的反应，使用血凝抑制（HI）分析将其定义为H1N1抗体滴度≥1：40。结果：从199例患者中收集了基线血液样本，其中154例同意接受疫苗接种。其中，有126例接种前和接种后HI滴度测定。 199名患者中有77名（38.7％）的基线抗体滴度≥1：40。八十五（67.4％）的滴度增加了四倍或更多，接种后109的109（86.5％）的抗体滴度≥1：40。 126对配对样品的血清HI H1N1抗体几何平均滴度（GMT）在接种前为39.32±3.46，在接种后增加至237.36±3.94 [标准偏差（SD）]（P <0.001）。在二元逻辑回归分析中，HIV病毒载量和基线HI抗体滴度与疫苗接种后HI H1N1抗体滴度显着相关。结论：在该人群中，疫苗接种前HI H1N1抗体的患病率很高，这与以前接触过H1N1流感病毒是一致的。接种疫苗的反应被认为是足够的，因为超过三分之二的患者接种疫苗后抗体滴度提高了四倍或更多。那些无HIV HIV的患者对疫苗接种的反应明显更高，这表明抗逆转录病毒疗法可改善体液反应，这对于优化疫苗效果非常重要。

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