Long-term immune response to yellow fever vaccination in HIV-infected individuals depends on HIV-RNA suppression status: Implications for vaccination schedule.

Veit, Olivia Stephanie; Domingo, Cristina; Niedrig, Matthias; Staehelin, Cornelia; Sonderegger, Beat; Delphine, Héquet; Stoeckle, Marcel; Calmy, Alexandra; Schiffer, Veronique; Bernasconi, Enos; Flury, Domenica; Hatz, Christoph; Zwahlen, Marcel; Furrer, Hansjakob (2018). Long-term immune response to yellow fever vaccination in HIV-infected individuals depends on HIV-RNA suppression status: Implications for vaccination schedule. Clinical infectious diseases, 66(7), pp. 1099-1108. Oxford University Press 10.1093/cid/cix960

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Background In HIV-infected individuals the immune response over time to yellow fever vaccination (YFV) and the necessity for booster vaccination are not well understood. Methods We studied 247 participants of the Swiss HIV Cohort Study (SHCS) with a first YFV after HIV diagnosis and determined their immune responses at one, five, and ten years postvaccination (p.v.) by yellow fever plaque reduction neutralisation titres (PRNT) in stored blood samples. A PRNT of 1:≥10 was regarded as reactive and protective. Predictors of vaccination response were analysed with Poisson regression. Results At vaccination, 82% of the vaccinees were taking combination antiretroviral therapy (cART), 83% had suppressed HIV RNA levels (<400 copies/ml), and their median CD4 cell count was 536 cells/mm3. PRNT was reactive in 46% (95% CI 38%-53%) before, 95% (91%-98%) within one year, 86% (79%-92%) at five years, and 75% (62%-85%) at 10 years p.v. In those with suppressed plasma HIV RNA at YVF, the proportion with reactive PRNT remained high: 99% (95%-99.8%) within one year, 99% (92%-100%) at five years, and 100% (86%-100%) at ten years. Conclusions HIV-infected patients' long-term immune response up to ten years to YFV is primarily dependent on the control of HIV replication at the time of vaccination. For those on successful cART, immune response up to ten years is comparable to that of non-HIV-infected adults. We recommend a single YFV booster after ten years for patients vaccinated on successful cART, while those vaccinated with uncontrolled HIV RNA may need an early booster.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Veit, Olivia Stephanie; Staehelin, Cornelia; Zwahlen, Marcel and Furrer, Hansjakob

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1058-4838

Publisher:

Oxford University Press

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

18 Dec 2017 14:18

Last Modified:

01 Dec 2018 02:30

Publisher DOI:

10.1093/cid/cix960

PubMed ID:

29140432

Uncontrolled Keywords:

CD4 count HIV-RNA HIV-infected patients HIV-infection Yellow fever vaccination antiretroviral therapy plaque reduction neutralisation test short- and long-term immune response

BORIS DOI:

10.7892/boris.107221

URI:

https://boris.unibe.ch/id/eprint/107221

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