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Vaccine. 2016 Aug 28. pii: S0264-410X(16)30432-7. doi: 10.1016/j.vaccine.2016.06.019. [Epub ahead of print]
Vitamin D levels and influenza vaccine immunogenicity among HIV-infected and HIV-uninfected adults.
Crum-Cianflone NF1, Won S2, Lee R3, Lalani T4, Ganesan A5, Burgess T6, Agan BK2.
Author information
Abstract
BACKGROUND:
Vaccination is the most important preventive strategy against influenza, however post-vaccination antibody responses are often inadequate especially among HIV-infected persons. Vitamin D deficiency has been suggested to adversely influence immune responses and is highly prevalent among HIV-infected adults. Therefore, we evaluated the association between 25-hydroxyvitamin D [25(OH)D] levels and post-influenza vaccination responses.
METHODS:
We conducted a prospective cohort study evaluating the immunogenicity of monovalent influenza A (H1N1) vaccination among both HIV-infected and HIV-uninfected adults (18-50years of age) during the 2009-2010 influenza season. Antibody titers were evaluated at baseline, day 28, and 6months post-vaccination using hemagluttination inhibition assays. Serum 25(OH)D levels were measured at day 28. Univariate and multivariate regression analyses examined the association between 25(OH)D levels [categorized as <20ng/ml (deficiency) vs. ⩾20ng/ml] with the primary outcome of seroconversion. Secondary outcomes included seroprotection; a ⩾4-fold increase in titers; and geometric mean titers post-vaccination. Analyses were repeated using 25(OH)D levels as a continuous variable.
RESULTS:
A total of 128 adults [64 HIV-infected (median CD4 count 580cells/mm3) and 64 HIV-uninfected] were included. Seroconversion at day 28 post-vaccination was achieved in fewer HIV-infected participants compared with HIV-uninfected participants (56% vs. 74%, p=0.03). Vitamin D deficiency was more prevalent among HIV-infected persons vs. HIV-uninfected persons (25% vs. 17%), although not significantly different (p=0.39). There were no associations found between lower 25(OH)D levels and poorer antibody responses at day 28 or 6months for any of the study outcomes among either HIV-infected or HIV-uninfected adults.
CONCLUSION:
Vitamin D deficiency was common among both HIV-infected and HIV-uninfected adults, but lower levels did not predict antibody responses after H1N1 (2009) influenza vaccination. Low 25(OH)D levels do not explain poorer post-vaccination responses among HIV-infected persons.
Copyright ? 2016 Elsevier Ltd. All rights reserved.
KEYWORDS:
HIV-infected persons; Immunogenicity; Influenza vaccine; Vitamin D level
PMID: 27577557 DOI: 10.1016/j.vaccine.2016.06.019
[PubMed - as supplied by publisher]
Vitamin D levels and influenza vaccine immunogenicity among HIV-infected and HIV-uninfected adults.
Crum-Cianflone NF1, Won S2, Lee R3, Lalani T4, Ganesan A5, Burgess T6, Agan BK2.
Author information
Abstract
BACKGROUND:
Vaccination is the most important preventive strategy against influenza, however post-vaccination antibody responses are often inadequate especially among HIV-infected persons. Vitamin D deficiency has been suggested to adversely influence immune responses and is highly prevalent among HIV-infected adults. Therefore, we evaluated the association between 25-hydroxyvitamin D [25(OH)D] levels and post-influenza vaccination responses.
METHODS:
We conducted a prospective cohort study evaluating the immunogenicity of monovalent influenza A (H1N1) vaccination among both HIV-infected and HIV-uninfected adults (18-50years of age) during the 2009-2010 influenza season. Antibody titers were evaluated at baseline, day 28, and 6months post-vaccination using hemagluttination inhibition assays. Serum 25(OH)D levels were measured at day 28. Univariate and multivariate regression analyses examined the association between 25(OH)D levels [categorized as <20ng/ml (deficiency) vs. ⩾20ng/ml] with the primary outcome of seroconversion. Secondary outcomes included seroprotection; a ⩾4-fold increase in titers; and geometric mean titers post-vaccination. Analyses were repeated using 25(OH)D levels as a continuous variable.
RESULTS:
A total of 128 adults [64 HIV-infected (median CD4 count 580cells/mm3) and 64 HIV-uninfected] were included. Seroconversion at day 28 post-vaccination was achieved in fewer HIV-infected participants compared with HIV-uninfected participants (56% vs. 74%, p=0.03). Vitamin D deficiency was more prevalent among HIV-infected persons vs. HIV-uninfected persons (25% vs. 17%), although not significantly different (p=0.39). There were no associations found between lower 25(OH)D levels and poorer antibody responses at day 28 or 6months for any of the study outcomes among either HIV-infected or HIV-uninfected adults.
CONCLUSION:
Vitamin D deficiency was common among both HIV-infected and HIV-uninfected adults, but lower levels did not predict antibody responses after H1N1 (2009) influenza vaccination. Low 25(OH)D levels do not explain poorer post-vaccination responses among HIV-infected persons.
Copyright ? 2016 Elsevier Ltd. All rights reserved.
KEYWORDS:
HIV-infected persons; Immunogenicity; Influenza vaccine; Vitamin D level
PMID: 27577557 DOI: 10.1016/j.vaccine.2016.06.019
[PubMed - as supplied by publisher]