BACKGROUND:Live-attenuated influenza vaccine (LAIV) prevents more cases of influenza in immune-competent children than the trivalent inactivated vaccine (TIV). We compared the antibody responses to LAIV or TIV in HIV-infected children. METHODS: Blood and saliva obtained at enrollment, 4 and 24 weeks postimmunization from 243 HIV-infected children randomly assigned to TIV or LAIV were analyzed. RESULTS: Both vaccines increased the anti-influenza neutralizing antibodies at 4 and 24 weeks postimmunization. At 4 weeks postimmunization, TIV recipients had 2-fold to 3-fold higher neutralizing antibody titers than LAIV recipients, but the proportions of subjects with protective titers (≥ 1:40) were similar between treatment groups (96%-100% for influenza A and 81%-88% for influenza B). Both vaccines increased salivary homotypic IgG antibodies, but not IgA antibodies. Both vaccines also increased serum heterosubtypic antibodies. Among HIV-specific characteristics, the baseline viral load correlated best with the antibody responses to either vaccine. We used LAIV-virus shedding as a surrogate of influenza infection. Influenza-specific humoral and mucosal antibody levels were significantly higher in nonshedders than in shedders. CONCLUSIONS:LAIV and TIV generated homotypic and heterosubtypic humoral and mucosal antibody responses in HIV-infected children. High titers of humoral or mucosal antibodies correlated with protection against viral shedding.
RCT Entities:
BACKGROUND: Live-attenuated influenza vaccine (LAIV) prevents more cases of influenza in immune-competent children than the trivalent inactivated vaccine (TIV). We compared the antibody responses to LAIV or TIV in HIV-infectedchildren. METHODS: Blood and saliva obtained at enrollment, 4 and 24 weeks postimmunization from 243 HIV-infectedchildren randomly assigned to TIV or LAIV were analyzed. RESULTS: Both vaccines increased the anti-influenza neutralizing antibodies at 4 and 24 weeks postimmunization. At 4 weeks postimmunization, TIV recipients had 2-fold to 3-fold higher neutralizing antibody titers than LAIV recipients, but the proportions of subjects with protective titers (≥ 1:40) were similar between treatment groups (96%-100% for influenza A and 81%-88% for influenza B). Both vaccines increased salivary homotypic IgG antibodies, but not IgA antibodies. Both vaccines also increased serum heterosubtypic antibodies. Among HIV-specific characteristics, the baseline viral load correlated best with the antibody responses to either vaccine. We used LAIV-virus shedding as a surrogate of influenza infection. Influenza-specific humoral and mucosal antibody levels were significantly higher in nonshedders than in shedders. CONCLUSIONS:LAIV and TIV generated homotypic and heterosubtypic humoral and mucosal antibody responses in HIV-infectedchildren. High titers of humoral or mucosal antibodies correlated with protection against viral shedding.
Authors: A M Iorio; A Alatri; D Francisci; R Preziosi; M Neri; I Donatelli; M R Castrucci; L R Biasio; C Tascini; R Iapoce; P Pierucci; F Baldelli Journal: Vaccine Date: 1997-01 Impact factor: 3.641
Authors: A Amendola; A Boschini; D Colzani; G Anselmi; A Oltolina; R Zucconi; M Begnini; S Besana; E Tanzi; A R Zanetti Journal: J Med Virol Date: 2001-12 Impact factor: 2.327
Authors: George K Siberry; Mark J Abzug; Sharon Nachman; Michael T Brady; Kenneth L Dominguez; Edward Handelsman; Lynne M Mofenson; Steve Nesheim Journal: Pediatr Infect Dis J Date: 2013-11 Impact factor: 2.129
Authors: Patricia M Flynn; Sharon Nachman; Petronella Muresan; Terence Fenton; Stephen A Spector; Coleen K Cunningham; Robert Pass; Ram Yogev; Sandra Burchett; Barbara Heckman; Anthony Bloom; L Jill Utech; Patricia Anthony; Elizabeth Petzold; Wende Levy; George K Siberry; Ruth Ebiasah; Judi Miller; Edward Handelsman; Adriana Weinberg Journal: J Infect Dis Date: 2012-05-21 Impact factor: 5.226
Authors: Robert F Pass; Sharon Nachman; Patricia M Flynn; Petronella Muresan; Terence Fenton; Coleen K Cunningham; William Borkowsky; James B McAuley; Stephen A Spector; Elizabeth Petzold; Wende Levy; George K Siberry; Ed Handelsman; L Jill Utech; Adriana Weinberg Journal: J Pediatric Infect Dis Soc Date: 2013-07-17 Impact factor: 3.164