ИММУННЫЙ ОТВЕТ НА ВАКЦИНАЦИЮ ПРОТИВ ГРИППА У БОЛЬНЫХ ВИЧ-ИНФЕКЦИЕЙ

The Aim : to characterize the immune response to the influenza vaccine in patients with HIV infection with different degrees of immunosuppression. Materials and methods. 171 HIV-infected adult patients with the different degrees of immunodeficiency and 50 HIV-uninfected persons (control group) were vaccinated against influenza. A single dose of trivalent polymer-subunit vaccine containing adjuvant was administered intramuscularly. The blood titer of antibodies to influenza virus antigens A/H1N1/California/, A/H3N2/Hong Kong/, B/Brisbane/ in the hemagglutination inhibition reaction was determined before vaccination and 21 and 180 days after. The average geometric titers of antibodies were compared between groups of HIV-infected patients with the different degrees of immunosuppression and the control group. Results. Тhe mean geometric antibody titers increase among HIV-infected with different degrees of immunodeficiency was below 2,0 and the seroconversion rate was below 8,0% for all influenza virus antigens on 21 and 180 days after vaccination. At the same time, during follow-up period in patients with level less than 200 cells /μl of CD4+lymphocytes in blood, the seroconversion index was equal to 0%. The rate of seroprotection to all antigens before vaccination in HIVinfected patients with the different degrees of immunosuppression was above 90%. Naturally, during follow-up period, more than 95,0% of vaccinated patients determined the protective level of antibodies to antigen A /H1N1 and 100,0% of patients to antigen A/H3N2 and B, without reducing this index to the day-180 of observation. Persons from control group showed a sufficient level of seroconversion and seroprotection, corresponding to the criteria of immunogenicity for all antigens of the influenza virus. Conclusion: a single immunization of influenza vaccine does not cause a sufficient degree of serological response in patients with HIV infection, regardless of the severity of immunodeficiency. Seroprotection in case of its developing persists up to 180 day after vaccination.