Effects of influenza vaccination in HIV-infected adults: a double-blind, placebo-controlled trial

Annual influenza vaccine is recommended for persons with HIV infection, Recent reports indicate that immunizations may increase HII replication in infected individuals, Forty-seven HIV-infected patients were randomized to influenza vaccine or saline placebo using a double blind study design, One month after-vaccination, plasma HIV-I RNA increased in the vaccinated but not placebo group (p=0.029) At 3 months, CD4% dropped an average of 1.6 points in the vaccinated group compared to an increase of 0.1 points in the placebo group (p = 0.039), Patients on stable antiretroviral regimens had CD4% drop an average of 2.3 points in the vaccinated group at 3 months versus 0.1 points in the placebo group (p = 0.015), It is concluded that HIV-infected patients are at risk for increased HIV replication and decreases in CD4% following influenza vaccination. Since influenza has not been associated with significant morbidity in this population, further study of routine influenza vaccination for HIV-infected patients is warranted. (C) 1998 Published by Elsevier-Science Ltd. All rights reserved.