Abstract
Introduction. HIV-infected individuals demonstrate lower immunogenicity to the influenza vaccine, despite immunologic and virologic control of HIV infection. Obesity has been previously shown to be associated with diminished antibody responses to other vaccines in HIV-uninfected persons. However, no studies have examined if obesity is associated with diminished protective immune response to influenza vaccination among HIV-infected persons on antiretroviral therapy (ART). Methods. We performed a retrospective analysis of immunogenicity data from a clinical trial of inactivated, trivalent influenza vaccine. The primary endpoint was the proportion of participants with seroconversion, defined as >4-fold increase in anti-hemagglutinin antibody titers after vaccination. Secondary endpoints were the proportion of participants with seroprotection (defined as antibody titers of ≥1 : 40) and geometric mean hemagglutination inhibition antibody titers. Results. Overall, 48 (27%) participants were obese (body mass index ≥ 30 kg/m2). Seroconversion rates were comparable between obese and nonobese subjects for all three vaccine strains. Further, postvaccination geometric mean titers did not differ by body mass index category. Conclusion. Obesity was not associated with diminished antibody response to influenza vaccination in a sample of healthy HIV-infected persons.
Highlights
HIV-infected individuals demonstrate lower immunogenicity to the influenza vaccine, despite immunologic and virologic control of HIV infection
This study evaluated if obesity was associated with diminished vaccine responsiveness to the 2010-2011 seasonal influenza vaccine in HIVinfected persons and examined whether a high dose vaccine formulation could improve immunogenicity among obese individuals
Of the 195 HIV-infected persons studied in the original clinical trial, data on body mass index (BMI) and influenza vaccine response were available for 176 persons (85 in the standard dose (SD) group; 91 in the high dose (HD) group)
Summary
HIV-infected individuals demonstrate lower immunogenicity to the influenza vaccine, despite immunologic and virologic control of HIV infection. Obesity has been previously shown to be associated with diminished antibody responses to other vaccines in HIV-uninfected persons. No studies have examined if obesity is associated with diminished protective immune response to influenza vaccination among HIV-infected persons on antiretroviral therapy (ART). Obesity was not associated with diminished antibody response to influenza vaccination in a sample of healthy HIV-infected persons. While low CD4 cell counts and HIV viremia are important determinants of vaccine response, they do not fully explain the reduced immunogenicity to influenza vaccine observed in this population, indicating that other factors contribute as well [5, 6]. Reduced immune responses to a candidate HIV-1 vaccine were seen among overweight, uninfected adults [11]. Excess peripheral adiposity may lead to inadequate vaccine delivery intramuscularly, reducing antigen uptake and presentation to the immune system [15]
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