Effect of Influenza Vaccination on HIV-infected Patients


Effect of Influenza Vaccination on HIV-infected Patients

Being Alive; November 1993
William A. O'Brien, MD

A pilot study was performed at UCLA to examine the effect of influenza vaccination on growth of the AIDS virus in the blood of HIV-infected patients having CD4 cell counts of 200-500. Transient increases in levels of circulating HIV were found in the blood of half of 16 patients during the month following vaccination. The increases were in most cases not sustained, and there were no increases detected in the other half of the patients. The importance of these findings on disease progression are not known, but there are probably many forms of stimulation, including acute infections, that can also increase HIV growth.

Because influenza virus infection may be more severe in individuals with immunodeficiency, the Centers for Disease Control (CDC) recommends annual influenza vaccination for all patients with HIV infection. This may be particularly important this year, when the expected influenza strain is predicted to cause more severe and long-lasting infection. Cases have been appearing earlier than usual this year, so early vaccination is advised. It is possible that influenza virus infection may cause greater stimulation of HIV growth than the vaccine. At present, it seems reasonable to continue to follow CDC guidelines for influenza vaccination.

(William A. O'Brien, MD is Assistant Professor, Division of Infectious Diseases, UCLA School of Medicine and Director of the HIV Clinic, VA Medical Center, Los Angeles.)
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