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Zhang T, Geng J, Du Y, Yang H, Jin Y, Chen S, Duan G. A meta-analysis of immunogenicity and safety of two versus single-doses of influenza A (H1N1) vaccine in person living with HIV. Int J STD AIDS 2024; 35:326-336. [PMID: 38087772 DOI: 10.1177/09564624231220424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Purpose: Influenza vaccination of person living with HIV (PLWH) is a powerful means to tackle severe clinical outcomes. Few data on two doses of influenza vaccine in PLWH are available.Research Design: To evaluate the immunogenicity and safety of two doses of vaccine as compared with single dose in PLWH, we searched Pubmed, Embase, and web of science databases for relevant articles (January 2009 to April 2023). Pooled SMD or RR and 95% CI were calculated.Results: A total of 2436 participants from 14 studies were included. Compared to single dose influenza vaccine regimen, the pooled RR of seroprotection and seroconversion for two doses of vaccines was 1.14 (95%CI: 1.08-1.21) and 1.25 (95%CI: 1.16-1.34), respectively; the SMD of GMT was 0.42 (95%CI: 0.35, 0.49). Regarding safety, the fever risk in PLWH receiving two doses of vaccine was 3.42 fold higher than that of single dose vaccine, and the risk of myalgia had a quarter reduction. No serious vaccine-related adverse events were reported.Conclusions: Collectively, two doses of the vaccine are associated with a better immunogenicity and an acceptable safety in PLWH. Two doses of the adjuvant vaccination might be a superior vaccination regimen.nation regimen.
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Affiliation(s)
- Teng Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, People's Republic of China
| | - Juan Geng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, People's Republic of China
| | - Yazhe Du
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, People's Republic of China
| | - Haiyan Yang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, People's Republic of China
| | - Yuefei Jin
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, People's Republic of China
| | - Shuaiyin Chen
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, People's Republic of China
| | - Guangcai Duan
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, People's Republic of China
- Henan Key Laboratory of Molecular Medicine, Zhengzhou University, Henan, People's Republic of China
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Chen YC, Zhou JH, Tian JM, Li BH, Liu LH, Wei K. Adjuvanted-influenza vaccination in patients infected with HIV: a systematic review and meta-analysis of immunogenicity and safety. Hum Vaccin Immunother 2019; 16:612-622. [PMID: 31567058 DOI: 10.1080/21645515.2019.1672492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Adjuvanted-influenza vaccination is an efficient method for enhancing the immunogenicity of influenza split-virus vaccines for preventing influenza. However, the medical community's understanding of its performance in patients infected with HIV remains limited. To identify the advantages, we conducted a systematic review and meta-analysis with randomized controlled trials (RCTs) and cohort and case-control studies that have the immunogenicity and safety of influenza vaccines in patients infected with HIV as outcomes. We searched six different databases, and 1698 patients infected with HIV in 11 studies were included. Statistical analysis was performed to calculate the pooled standardized mean differences (SMD) or relative risk (RR) and 95% confidence interval (CI). Regarding immunogenicity, the pooled SMD of GMT (Geometric mean titer) for A/H1N1 was 0.61 (95%CI (0.40,0.82)), the pooled RR of seroconversion was 1.34 (95%CI (0.91,1.98)) for the H1N1 vaccine, 1.27(95%CI (0.64,2.52)) for the H3N2 vaccine, 1.19(95%CI (0.97,1.46)) for the B-type influenza vaccine. The pooled RR of seroprotection was 1.61 (95%CI (1.00,2.58)) for the H1N1 vaccine, 1.06 (95%CI(0.83,1.35)) for the H3N2 vaccine, and 1.13(95%CI(0.91,1.41)) for the B-type vaccine. Adjuvanted-influenza vaccination showed good general tolerability in patients infected with HIV, with the only significant increase being the rate of local pain at the injection site (RR = 2.03, 95%CI (1.06,3.86)). In conclusion, all studies evaluating injected adjuvanted influenza vaccination among patients infected with HIV showed acceptable levels of safety and immunogenicity.
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Affiliation(s)
- Yong-Chao Chen
- Medical school, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Jia-Hao Zhou
- Medical school, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Jia-Ming Tian
- Medical school, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Bai-Hui Li
- Medical school, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Li-Hui Liu
- Medical school, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Ke Wei
- Medical school, Hunan University of Chinese Medicine, Changsha, Hunan, China
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Geretti AM, Brook G, Cameron C, Chadwick D, French N, Heyderman R, Ho A, Hunter M, Ladhani S, Lawton M, MacMahon E, McSorley J, Pozniak A, Rodger A. British HIV Association Guidelines on the Use of Vaccines in HIV-Positive Adults 2015. HIV Med 2018; 17 Suppl 3:s2-s81. [PMID: 27568789 DOI: 10.1111/hiv.12424] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Anna Maria Geretti
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | | | | | | | | | | | | | | | | | - Mark Lawton
- Royal Liverpool University Hospital, Liverpool, UK
| | - Eithne MacMahon
- Guy's & St Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
| | | | - Anton Pozniak
- Chelsea and Westminster Hospital, NHS Foundation Trust, London, UK
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Zhang W, Sun H, Atiquzzaman M, Sou J, Anis AH, Cooper C. Influenza vaccination for HIV-positive people: Systematic review and network meta-analysis. Vaccine 2018; 36:4077-4086. [PMID: 29859802 DOI: 10.1016/j.vaccine.2018.05.077] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 04/30/2018] [Accepted: 05/21/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND People with Human Immunodeficiency Virus (HIV) are highly susceptible to influenza-related morbidity and mortality. In order to assess comparative efficacy of influenza vaccine strategies among HIV-positive people, we performed a systematic review and Bayesian network meta-analysis (NMA). METHODS In this systematic review, we searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and CINAHL between 1946 and July 2015 for randomized controlled trials (RCTs) on influenza vaccines for HIV-positive adults reporting seroconversion or seroprotection outcomes. The NMAs were conducted within a Bayesian framework and logistic models were used for comparing the effect of the vaccine strategies on the two outcomes. RESULTS A total of 1957 publications were identified, 143 were selected for full review, and 13 RCTs were included in our final analysis. Fourteen separate NMAs were conducted by outcomes, vaccine strain, and different outcome measurement timepoints. For example, compared with the 15 μg single vaccine strategy, the odds ratio was the highest for the adjuvant 7.5 μg booster strategy (2.99 [95% credible interval 1.18-7.66]) when comparing seroconversion for H1N1 at 14-41 days after the last dose of vaccination and for the 60 μg single strategy (2.33 [1.31-4.18]) when comparing seroconversion for strain B. CONCLUSIONS The adjuvant 7.5 μg booster and 60 μg single vaccine strategies provided better seroconversion and seroprotection outcomes. These findings have important implications for national and international guidelines for influenza vaccination for HIV-positive people and future research.
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Affiliation(s)
- Wei Zhang
- School of Population and Public Health, University of British Columbia, Canada; Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Canada.
| | - Huiying Sun
- Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Canada
| | | | - Julie Sou
- Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Canada
| | - Aslam H Anis
- School of Population and Public Health, University of British Columbia, Canada; Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Canada
| | - Curtis Cooper
- Department of Medicine, University of Ottawa, Canada
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5
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Seo YB, Lee J, Song JY, Choi HJ, Cheong HJ, Kim WJ. Safety and immunogenicity of influenza vaccine among HIV-infected adults: Conventional vaccine vs. intradermal vaccine. Hum Vaccin Immunother 2016; 12:478-84. [PMID: 26431466 DOI: 10.1080/21645515.2015.1076599] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Several studies have reported poor immune responses to conventional influenza vaccines in HIV-infected individuals. This study sought to elicit more potent immunogenicity in HIV-infected adults using an intradermal vaccine compared with a conventional intramuscular vaccine. This multicenter, randomized, controlled, open-label study was conducted at 3 university hospitals during the 2011/2012 pre-influenza season. Three vaccines were used in HIV-infected adults aged 18 - 60 years: an inactivated intramuscular vaccine (Agrippal), a reduced-content intradermal vaccine (IDflu9μg) and a standard-content intradermal vaccine (IDflu15μg). Serum hemagglutination-inhibiting (HI) antibodies and INF-γ ELISpot assay were measured at the time of vaccination and 1 month after vaccination. Adverse events were recorded for 7 d. A total of 28 Agrippal, 30 IDflu9μg, and 28 IDflu15μg volunteers were included in this analysis. One month after vaccination, the GMTs and differences in INF-γ ELISpot assay results were similar among the 3 groups. Seroprotection rates, seroconversion rates and mean fold increases (MFI) among the 3 groups were also similar, at approximately 80%, 50-60% and 2.5 - 10.0, respectively. All three vaccines satisfied the CHMP criteria for the A/H1N1 and A/H3N2 strains, but not those for the B strain. In univariate analysis, no demographic or clinical factors, including age, CD4+ T-cell counts, HIV viral load, ART status and vaccine type, were related to failure to achieve seroprotection. The three vaccines were all well-tolerated and all reported reactions were mild to moderate. However, there was a tendency toward a higher incidence of local and systemic reactions in the intradermal vaccine groups. The intradermal vaccine did not result in higher immunogenicity compared to the conventional intramuscular vaccine, even with increased antigen dose.
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Affiliation(s)
- Yu Bin Seo
- a Division of Infectious Diseases ; Department of Internal Medicine; Hallym University College of Medicine ; Chuncheon , Republic of Korea
| | - Jacob Lee
- a Division of Infectious Diseases ; Department of Internal Medicine; Hallym University College of Medicine ; Chuncheon , Republic of Korea
| | - Joon Young Song
- b Division of Infectious Diseases ; Department of Internal Medicine; Korea University College of Medicine ; Seoul , Republic of Korea
| | - Hee Jung Choi
- c Division of Infectious Diseases ; Department of Internal Medicine; Ewha Woman University College of Medicine ; Seoul , Republic of Korea
| | - Hee Jin Cheong
- b Division of Infectious Diseases ; Department of Internal Medicine; Korea University College of Medicine ; Seoul , Republic of Korea
| | - Woo Joo Kim
- b Division of Infectious Diseases ; Department of Internal Medicine; Korea University College of Medicine ; Seoul , Republic of Korea
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Souza TML, Santini-Oliveira M, Martorelli A, Luz PM, Vasconcellos MTL, Giacoia-Gripp CBW, Morgado M, Nunes EP, Lemos AS, Ferreira ACG, Moreira RI, Veloso VG, Siqueira M, Grinsztejn B, Camacho LAB. Immunogenicity and sustainability of the immune response in Brazilian HIV-1-infected individuals vaccinated with inactivated triple influenza vaccine. J Med Virol 2015; 88:426-36. [PMID: 26267817 DOI: 10.1002/jmv.24351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2015] [Indexed: 01/13/2023]
Abstract
HIV-infected individuals have a higher risk of serious illnesses following infection by infection with influenza. Although anti-influenza vaccination is recommended, immunosuppression may limit their response to active immunization. We followed-up a cohort of HIV-infected individuals vaccinated against influenza to assess the immunogenicity and sustainability of the immune response to vaccination. Individuals were vaccinated 2011 with inactivated triple influenza vaccine (TIV), and they had received in 2010 the monovalent anti-A(H1N1)pdm09 vaccine. The sustainability of the immune response to A(H1N1)pdm09 at 12 months after monovalent vaccination fell, both in individuals given two single or two double doses. For these individuals, A(H1N1)pdm09 component from TIV acted as a booster, raising around 40% the number of seroprotected individuals. Almost 70% of the HIV-infected individuals were already seroprotected to A/H3N2 at baseline. Again, TIV boosted over 90% the seroprotection to A/H3N2. Anti-A/H3N2 titers dropped by 20% at 6 months after vaccination. Pre-vaccination seroprotection rate to influenza B (victoria lineage) was the lowest among those tested, seroconversion rates were higher after vaccination. Seroconversion/protection after TIV vaccination did not differ significantly across categories of clinical and demographic variables. Anti-influenza responses in Brazilian HIV-infected individuals reflected both the previous history of virus circulation in Brazil and vaccination.
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Affiliation(s)
- Thiago Moreno L Souza
- Laboratório de Vírus Respiratórios e do Sarampo, NIC-WHO, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.,Centro de Desenvolvimento Tecnológico em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.,Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Andressa Martorelli
- Laboratório de Vírus Respiratórios e do Sarampo, NIC-WHO, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.,Centro de Desenvolvimento Tecnológico em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.,Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Paula M Luz
- Instituto de Pesquisas Clínicas Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Carmem B W Giacoia-Gripp
- Laboratório de Aids e Imunologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Mariza Morgado
- Laboratório de Aids e Imunologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Estevão P Nunes
- Instituto de Pesquisas Clínicas Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Alberto S Lemos
- Instituto de Pesquisas Clínicas Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Ana C G Ferreira
- Instituto de Pesquisas Clínicas Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Ronaldo I Moreira
- Instituto de Pesquisas Clínicas Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Valdiléa G Veloso
- Instituto de Pesquisas Clínicas Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Marilda Siqueira
- Laboratório de Vírus Respiratórios e do Sarampo, NIC-WHO, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Beatriz Grinsztejn
- Instituto de Pesquisas Clínicas Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Luiz A B Camacho
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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Martins RDM, Possas CDA, Homma A. Historical review of clinical vaccine studies at Oswaldo Cruz Institute and Oswaldo Cruz Foundation--technological development issues. Mem Inst Oswaldo Cruz 2015; 110:114-24. [PMID: 25742271 PMCID: PMC4371225 DOI: 10.1590/0074-02760140346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 12/05/2014] [Indexed: 12/03/2022] Open
Abstract
This paper presents, from the perspective of technological development and
production, the results of an investigation examining 61 clinical studies with
vaccines conducted in Brazil between 1938-2013, with the participation of the Oswaldo
Cruz Institute (IOC) and the Oswaldo Cruz Foundation (Fiocruz). These studies have
been identified and reviewed according to criteria, such as the kind of vaccine
(viral, bacterial, parasitic), their rationale, design and methodological strategies.
The results indicate that IOC and Fiocruz have accumulated along this time
significant knowledge and experience for the performance of studies in all clinical
phases and are prepared for the development of new vaccines products and processes.
We recommend national policy strategies to overcome existing regulatory and financing
constraints.
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Affiliation(s)
| | | | - Akira Homma
- Bio-Manguinhos-Fiocruz, Rio de Janeiro, RJ, Brasil
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Homma A, Tanuri A, Duarte AJS, Marques E, de Almeida A, Martins R, Silva-Junior JB, Possas C. Vaccine research, development, and innovation in Brazil: a translational science perspective. Vaccine 2014; 31 Suppl 2:B54-60. [PMID: 23598493 DOI: 10.1016/j.vaccine.2012.11.084] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 11/04/2012] [Accepted: 11/28/2012] [Indexed: 11/17/2022]
Abstract
This article examines the Brazilian innovation policy for vaccines and its impact on infectious diseases, with emphasis on advances in translational science. The results indicate significant progress, with a rapid increase over the past two decades in the number of vaccine research groups, indicating scientific excellence. Advances and gaps in technological development and in public-private partnership initiatives were also identified. We stress the crucial role of partnerships, technology transfer, and targeted policies that could accelerate Brazil's participation in global vaccine research and development. We propose that new strategies should be urgently conceived to strengthen the links between the scientific and technological policies, the National Health System, and the National Immunizations Program in Brazil to provide access to low-cost vaccines to address major public health challenges. We also discuss the lessons learned from the Brazilian experience in the implementation of governmental policies on vaccine innovation that could be applicable to other developing countries.
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Affiliation(s)
- Akira Homma
- Bio-Manguinhos, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
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