Long-term follow-up in patients with HIV vaccinated with pandemic influenza A(H1N1)/09 AS03-adjuvanted split virion vaccine and seasonal trivalent influenza split virion vaccine

INTRODUCTION In Sweden in 2009, two doses of the pandemic influenza A(H1N1)/09 AS03-adjuvanted split virion vaccine were recommended for those with HIV infection along with one dose of seasonal trivalent influenza vaccine (TIV). At that time, no data for HIV patients and their response to the adjuvanted vaccine were available. METHODS Forty-two HIV-infected individuals were vaccinated with the pandemic vaccine on study days 0 and 28. Twenty-one of them received TIV on day 56 and 21 did not. Serum samples were taken at these time points, and also on day 86 and after 1 year for serologic analyses. RESULTS Before vaccination, none of the 42 patients had putatively protective levels of antibodies (haemagglutination inhibition [HI] titres ≥1:40) to the pandemic-like strain A/California/7/2009 H1N1. After dose 1, the seroprotection rate (SPR) and seroconversion rate (SCR) were both 69% (29 of 42). After dose 2, the SPR and SCR were 89 and 86%, respectively. At 1 year, 10 (34%) of 29 had protective antibodies and 16 (62%) of 26 who had had protective antibody levels had lost them. There was a retained factor increase of the geometric mean titre (GMT) of 3.9. Serological analyses could be performed in 19 subjects who were vaccinated with TIV and in 21 who were not. Protective antibodies to the three strains before vaccination were 20-37%. The SCR was 26% to A/Brisbane/59/2007 H1N1, 47% to A/Uruguay/10/2007/ H3N2 and 42% to B/Brisbane/60/2008. At 1 year, the factor increase of GMT was 1.8 to the two influenza A strains. CONCLUSION Two doses of adjuvanted influenza vaccine improved the SCR and the SPR among HIV-infected subjects. Long-term follow-up indicates revaccination in the next influenza season whether they received an adjuvanted or non-adjuvanted influenza vaccine.