Durability of antibody responses after receipt of the monovalent 2009 pandemic influenza A (H1N1) vaccine among HIV-infected and HIV-uninfected adults

Nancy F. Crum-Cianflone, Erik Iverson, Gabriel Defang, Patrick J. Blair, Lynn E. Eberly, Jason Maguire, Anuradha Ganesan, Dennis Faix, Christopher Duplessis, Tahaniyat Lalani, Timothy Whitman, Carolyn Brandt, Grace Macalino, Eugene V. Millar, Timothy Burgess

Research output: Contribution to journalArticle

Abstract

Background: Human immunodeficiency virus (HIV)-infected persons are at risk for severe influenza infections. Although vaccination against the H1N1 pandemic influenza strain is recommended, currently there are no data on the durability of post-vaccination antibody responses in this population. Methods: HIV-infected and HIV-uninfected adults (18-50 years old) received a single dose of monovalent 2009 influenza A (H1N1) vaccine (strain A/California/7/2009H1N1). Antibody levels to the 2009 H1N1 pandemic strain were determined at day 0, day 28, and 6 months by hemagglutination-inhibition assay. A seroprotective response was a post-vaccination titer of ≥1:40 among those with a pre-vaccination level of ≤1:10. Geometric mean titers (GMT) and factors associated with higher levels were also evaluated. Results: We studied 127 participants with a median age of 35 (interquartile range (IQR) 28, 42) years. Among the HIV-infected arm (n=63), the median CD4 count was 595 (IQR 476, 819)cells/mm3 and 83% were receiving HAART. Thirty-five percent of all participants had a pre-vaccination level of >1:10. HIV-infected compared to HIV-uninfected adults were less likely to generate a seroprotective response at day 28 (54% vs. 75%, adjusted OR 0.23, p=0.021) or have a durable response at 6 months post-vaccination (28% vs. 56%, adjusted OR 0.19, p=0.005). Additionally, although pre-vaccination GMT were similar in both arms (median 7 vs. 8, p=0.11), the GMT at 6 months was significantly lower among HIV-infected versus HIV-uninfected adults (median 20 vs. 113, p=0.003). Among HIV-infected persons, younger age (p=0.035) and receipt of HAART (p=0.028) were associated with higher GMTs at 6 months. Conclusions: Despite vaccination, most HIV-infected adults do not generate durable seroprotective antibody responses to the 2009 influenza A (H1N1) virus, and hence may remain vulnerable to infection. In addition to HAART use, more immunogenic vaccines are likely needed for improving protection against influenza in this population.

Original languageEnglish (US)
Pages (from-to)3183-3191
Number of pages9
JournalVaccine
Volume29
Issue number17
DOIs
StatePublished - Apr 12 2011
Externally publishedYes

Fingerprint

Human immunodeficiency virus
Pandemics
pandemic
durability
influenza
Human Influenza
Antibody Formation
Vaccines
HIV
vaccines
Vaccination
antibodies
vaccination
Highly Active Antiretroviral Therapy
H1N1 Subtype Influenza A Virus
hemagglutination inhibition test
Influenza A virus
Hemagglutination
CD4 Lymphocyte Count
Infection

Keywords

  • Durability
  • HIV
  • Influenza
  • Long-term immunity
  • Pandemic 2009 H1N1
  • Vaccine responses

ASJC Scopus subject areas

  • Immunology and Microbiology(all)
  • Infectious Diseases
  • Public Health, Environmental and Occupational Health
  • veterinary(all)
  • Molecular Medicine

Cite this

Crum-Cianflone, N. F., Iverson, E., Defang, G., Blair, P. J., Eberly, L. E., Maguire, J., ... Burgess, T. (2011). Durability of antibody responses after receipt of the monovalent 2009 pandemic influenza A (H1N1) vaccine among HIV-infected and HIV-uninfected adults. Vaccine, 29(17), 3183-3191. https://doi.org/10.1016/j.vaccine.2011.02.040

Durability of antibody responses after receipt of the monovalent 2009 pandemic influenza A (H1N1) vaccine among HIV-infected and HIV-uninfected adults. / Crum-Cianflone, Nancy F.; Iverson, Erik; Defang, Gabriel; Blair, Patrick J.; Eberly, Lynn E.; Maguire, Jason; Ganesan, Anuradha; Faix, Dennis; Duplessis, Christopher; Lalani, Tahaniyat; Whitman, Timothy; Brandt, Carolyn; Macalino, Grace; Millar, Eugene V.; Burgess, Timothy.

In: Vaccine, Vol. 29, No. 17, 12.04.2011, p. 3183-3191.

Research output: Contribution to journalArticle

Crum-Cianflone, NF, Iverson, E, Defang, G, Blair, PJ, Eberly, LE, Maguire, J, Ganesan, A, Faix, D, Duplessis, C, Lalani, T, Whitman, T, Brandt, C, Macalino, G, Millar, EV & Burgess, T 2011, 'Durability of antibody responses after receipt of the monovalent 2009 pandemic influenza A (H1N1) vaccine among HIV-infected and HIV-uninfected adults', Vaccine, vol. 29, no. 17, pp. 3183-3191. https://doi.org/10.1016/j.vaccine.2011.02.040
Crum-Cianflone, Nancy F. ; Iverson, Erik ; Defang, Gabriel ; Blair, Patrick J. ; Eberly, Lynn E. ; Maguire, Jason ; Ganesan, Anuradha ; Faix, Dennis ; Duplessis, Christopher ; Lalani, Tahaniyat ; Whitman, Timothy ; Brandt, Carolyn ; Macalino, Grace ; Millar, Eugene V. ; Burgess, Timothy. / Durability of antibody responses after receipt of the monovalent 2009 pandemic influenza A (H1N1) vaccine among HIV-infected and HIV-uninfected adults. In: Vaccine. 2011 ; Vol. 29, No. 17. pp. 3183-3191.
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abstract = "Background: Human immunodeficiency virus (HIV)-infected persons are at risk for severe influenza infections. Although vaccination against the H1N1 pandemic influenza strain is recommended, currently there are no data on the durability of post-vaccination antibody responses in this population. Methods: HIV-infected and HIV-uninfected adults (18-50 years old) received a single dose of monovalent 2009 influenza A (H1N1) vaccine (strain A/California/7/2009H1N1). Antibody levels to the 2009 H1N1 pandemic strain were determined at day 0, day 28, and 6 months by hemagglutination-inhibition assay. A seroprotective response was a post-vaccination titer of ≥1:40 among those with a pre-vaccination level of ≤1:10. Geometric mean titers (GMT) and factors associated with higher levels were also evaluated. Results: We studied 127 participants with a median age of 35 (interquartile range (IQR) 28, 42) years. Among the HIV-infected arm (n=63), the median CD4 count was 595 (IQR 476, 819)cells/mm3 and 83{\%} were receiving HAART. Thirty-five percent of all participants had a pre-vaccination level of >1:10. HIV-infected compared to HIV-uninfected adults were less likely to generate a seroprotective response at day 28 (54{\%} vs. 75{\%}, adjusted OR 0.23, p=0.021) or have a durable response at 6 months post-vaccination (28{\%} vs. 56{\%}, adjusted OR 0.19, p=0.005). Additionally, although pre-vaccination GMT were similar in both arms (median 7 vs. 8, p=0.11), the GMT at 6 months was significantly lower among HIV-infected versus HIV-uninfected adults (median 20 vs. 113, p=0.003). Among HIV-infected persons, younger age (p=0.035) and receipt of HAART (p=0.028) were associated with higher GMTs at 6 months. Conclusions: Despite vaccination, most HIV-infected adults do not generate durable seroprotective antibody responses to the 2009 influenza A (H1N1) virus, and hence may remain vulnerable to infection. In addition to HAART use, more immunogenic vaccines are likely needed for improving protection against influenza in this population.",
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T1 - Durability of antibody responses after receipt of the monovalent 2009 pandemic influenza A (H1N1) vaccine among HIV-infected and HIV-uninfected adults

AU - Crum-Cianflone, Nancy F.

AU - Iverson, Erik

AU - Defang, Gabriel

AU - Blair, Patrick J.

AU - Eberly, Lynn E.

AU - Maguire, Jason

AU - Ganesan, Anuradha

AU - Faix, Dennis

AU - Duplessis, Christopher

AU - Lalani, Tahaniyat

AU - Whitman, Timothy

AU - Brandt, Carolyn

AU - Macalino, Grace

AU - Millar, Eugene V.

AU - Burgess, Timothy

PY - 2011/4/12

Y1 - 2011/4/12

N2 - Background: Human immunodeficiency virus (HIV)-infected persons are at risk for severe influenza infections. Although vaccination against the H1N1 pandemic influenza strain is recommended, currently there are no data on the durability of post-vaccination antibody responses in this population. Methods: HIV-infected and HIV-uninfected adults (18-50 years old) received a single dose of monovalent 2009 influenza A (H1N1) vaccine (strain A/California/7/2009H1N1). Antibody levels to the 2009 H1N1 pandemic strain were determined at day 0, day 28, and 6 months by hemagglutination-inhibition assay. A seroprotective response was a post-vaccination titer of ≥1:40 among those with a pre-vaccination level of ≤1:10. Geometric mean titers (GMT) and factors associated with higher levels were also evaluated. Results: We studied 127 participants with a median age of 35 (interquartile range (IQR) 28, 42) years. Among the HIV-infected arm (n=63), the median CD4 count was 595 (IQR 476, 819)cells/mm3 and 83% were receiving HAART. Thirty-five percent of all participants had a pre-vaccination level of >1:10. HIV-infected compared to HIV-uninfected adults were less likely to generate a seroprotective response at day 28 (54% vs. 75%, adjusted OR 0.23, p=0.021) or have a durable response at 6 months post-vaccination (28% vs. 56%, adjusted OR 0.19, p=0.005). Additionally, although pre-vaccination GMT were similar in both arms (median 7 vs. 8, p=0.11), the GMT at 6 months was significantly lower among HIV-infected versus HIV-uninfected adults (median 20 vs. 113, p=0.003). Among HIV-infected persons, younger age (p=0.035) and receipt of HAART (p=0.028) were associated with higher GMTs at 6 months. Conclusions: Despite vaccination, most HIV-infected adults do not generate durable seroprotective antibody responses to the 2009 influenza A (H1N1) virus, and hence may remain vulnerable to infection. In addition to HAART use, more immunogenic vaccines are likely needed for improving protection against influenza in this population.

AB - Background: Human immunodeficiency virus (HIV)-infected persons are at risk for severe influenza infections. Although vaccination against the H1N1 pandemic influenza strain is recommended, currently there are no data on the durability of post-vaccination antibody responses in this population. Methods: HIV-infected and HIV-uninfected adults (18-50 years old) received a single dose of monovalent 2009 influenza A (H1N1) vaccine (strain A/California/7/2009H1N1). Antibody levels to the 2009 H1N1 pandemic strain were determined at day 0, day 28, and 6 months by hemagglutination-inhibition assay. A seroprotective response was a post-vaccination titer of ≥1:40 among those with a pre-vaccination level of ≤1:10. Geometric mean titers (GMT) and factors associated with higher levels were also evaluated. Results: We studied 127 participants with a median age of 35 (interquartile range (IQR) 28, 42) years. Among the HIV-infected arm (n=63), the median CD4 count was 595 (IQR 476, 819)cells/mm3 and 83% were receiving HAART. Thirty-five percent of all participants had a pre-vaccination level of >1:10. HIV-infected compared to HIV-uninfected adults were less likely to generate a seroprotective response at day 28 (54% vs. 75%, adjusted OR 0.23, p=0.021) or have a durable response at 6 months post-vaccination (28% vs. 56%, adjusted OR 0.19, p=0.005). Additionally, although pre-vaccination GMT were similar in both arms (median 7 vs. 8, p=0.11), the GMT at 6 months was significantly lower among HIV-infected versus HIV-uninfected adults (median 20 vs. 113, p=0.003). Among HIV-infected persons, younger age (p=0.035) and receipt of HAART (p=0.028) were associated with higher GMTs at 6 months. Conclusions: Despite vaccination, most HIV-infected adults do not generate durable seroprotective antibody responses to the 2009 influenza A (H1N1) virus, and hence may remain vulnerable to infection. In addition to HAART use, more immunogenic vaccines are likely needed for improving protection against influenza in this population.

KW - Durability

KW - HIV

KW - Influenza

KW - Long-term immunity

KW - Pandemic 2009 H1N1

KW - Vaccine responses

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