PEDIATRICS Vol. 98 No. 2 August 1996, pp. 348
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Church, J. A.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Church, J. A.

HUMAN IMMUNODEFICIENCY VIRUS TYPE 1 REPLICATION CAN BE INCREASED IN PERIPHERAL BLOOD OF SEROPOSITIVE PATIENTS AFTER INFLUENZA VACCINATION

Joseph A. Church MD1

1 Los Angeles, CA

Purpose of the Study. Immune activation in vitro and in vivo appear to upregulate human immunodeficiency virus (HIV) replication. The purpose of this study was to determine the effect of influenza vaccination on HIV replication in clinically stable adults with HIV.

Study Population. Thirty-four HIV-seropositive adult patients with intermediate stage disease were entered into the study. Twenty patients received influenza vaccination and 14 did not.

Methods. Blood was collected on three occasions during the month before influenza vaccination, during the first week, the second week, and 4 to 6 weeks after vaccination. Samples from each patient were batched and quantitative polymerase chain reaction (PCR) analysis was used to measure HIV DNA and RNA in peripheral blood mononuclear cells.

Results. Influenza vaccination did not increase HIV DNA in the peripheral blood of these patients. However, vaccination was associated with a greater than fourfold increase in HIV RNA in 50% of vaccinated patients. Peak increases in HIV RNA occurred one to two weeks postvaccination and returned to baseline at later points. At more than 3 years mean follow-up, the pattern of virologic response to influenza vaccination (increased HIV RNA vs no increase) did not predict clinical outcome.

Reviewer's Comments. The transient increase in HIV replication after influenza vaccination in adults has also been seen on other adult studies with pneumococcal vaccination. Although in these studies increased viremia was transient, the situation for perinatally-infected children receiving repeated multiple vaccinations over the first 2 years of life is yet to be determined.