Document 0967
 DOCN  M9470967
 TI    Antibody response to influenza, tetanus and pneumococcal vaccines in
       HIV-seropositive individuals in relation to the number of CD4+
       lymphocytes.
 DT    9409
 AU    Kroon FP; van Dissel JT; de Jong JC; van Furth R; Department of
       Infectious Diseases, University Hospital Leiden,; The Netherlands.
 SO    AIDS. 1994 Apr;8(4):469-76. Unique Identifier : AIDSLINE MED/94280718
 AB    OBJECTIVE: To establish when the formation of antibodies against
       T-lymphocyte-dependent and -independent antigens is impaired during HIV
       infection. DESIGN: Prospective study on antibody formation before and 30
       days and 60 days after vaccination with tetravalent influenza vaccine,
       tetanus toxoid and pneumococcal vaccine; booster with influenza vaccine
       was administered 30 days after initial vaccination. SETTING: Outpatient
       clinic of University Hospital Leiden. PARTICIPANTS: Fifty-one
       HIV-infected individuals and 10 healthy controls. RESULTS: In
       HIV-infected individuals with < 100 x 10(6)/l CD4+ lymphocytes almost no
       influenza antibodies were formed; CD4+ counts between 100 and 300 x
       10(6)/l correlated with suboptimal antibody formation; CD4+ counts > or
       = 300 x 10(6)/l yielded more individuals with protective antibody
       titres. Thirty days after vaccination, protective antibody titres
       against the four influenza strains had been achieved in 24% of all
       HIV-infected individuals for A/Beijing (H3N2) (controls, 90%), 59% for
       A/Taiwan (H1N1) (controls, 80%), 18% for B/Beijing (controls, 30%) and
       37% for B/Panama (controls 90%). Booster vaccination after 1 month did
       not increase antibody levels. Anti-tetanus toxin antibody formation,
       which is also T-lymphocyte-dependent, was correlated with the number of
       CD4+ lymphocytes. After pneumococcal vaccination
       (T-lymphocyte-independent), normal antibody formation was observed in
       HIV-infected individuals, including those with low CD4+ counts.
       CONCLUSIONS: Influenza vaccination should not be administered to
       HIV-infected individuals with CD4+ counts < 100 x 10(6)/l; pneumococcal
       vaccination can be offered to all HIV-infected individuals and a tetanus
       toxoid booster should be administered when indicated.
 DE    Adult  Antibodies, Bacterial/*BIOSYNTHESIS  Antibodies,
       Viral/*BIOSYNTHESIS  Bacterial Vaccines/IMMUNOLOGY  Female  Human  HIV
       Infections/*IMMUNOLOGY  HIV Seropositivity/IMMUNOLOGY  Influenza
       Vaccine/IMMUNOLOGY  Leukocyte Count  Male  Middle Age  Prospective
       Studies  Regression Analysis  Streptococcus pneumoniae/IMMUNOLOGY
       Tetanus Toxoid/IMMUNOLOGY  *T4 Lymphocytes  Vaccination
       Vaccines/*IMMUNOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).