a risk factor for morbidity and mortality caused by a

number of infections that can usually be prevented by

immunization.

• defects in cell-mediated immunity,

• B cell dysfunction, and suboptimal humoral immune
responses (1)
•.
 less immunogenic
and antibody responses shorter lived
 generally safe and acceptable

with
some vaccines administration of inactivated vaccines
does not have to be delayed if these have not yet
been achieved
 CD4 cell percentage ≥15
percent (if <5 years old) or cell counts ≥200
cells/microL (if ≥5 years old).
• Live vaccines should not be given to HIV-infected
individuals with CD4 cell parameters below these
thresholds
• Inactivated seasonal influenza vaccine
• The inactivated vaccine formulation is recommended for
the 2016-2017 influenza season;
• The specific schedule and inactivated vaccine components
are the same as for the general population and are
discussed elsewhere.
 vaccination is recommended for all PLHIV
before the annual influenza season.
• In a systematic review of studies evaluating the efficacy of
influenza vaccination,
• the rate of influenza-like illness (in 13 studies) and
laboratory confirmed influenza (in four studies) was
lower among vaccinated compared with unvaccinated
HIV-infected patients;
• the rate of influenza-like illness was comparable to
that in vaccinated patients without immune
compromise
• reductions in respiratory symptoms (29 versus 49
percent) and
• laboratory-confirmed infection (0 versus 21 percent)
[27].
• vaccination was associated with a lower risk of
subsequent laboratory-confirmed influenza among the
262 who agreed to immunization compared with the 66
who did not (relative risk 0.29) (22)
• is whether using a high-dose influenza vaccine will
improve immunogenicity and efficacy in HIV-infected
individuals.
• The question of immunogenicity was addressed in a
randomized trial that compared a standard dose (15 mcg
of antigen per strain) with a high dose (60 mcg per strain)
of the inactivated trivalent influenza vaccine in HIV-
infected individuals (34)
 the high-dose H1N1
influenza A (96 versus 87 percent) and influenza B (91
versus 80 percent) components, but not for H3N2
influenza A (96 versus 92 percent, a non-significant
difference)

• Intradermal delivery of influenza vaccine

did not improve
seroconversion rates
.
no studies
 , a poor vaccine response can
be expected in patients with HIV, particularly those with
advanced disease.
• Loss of CD4 cells weak influenza-specific
antibody responses,

the vaccine has been questioned for patients with

more advanced disease on a cost-benefit basis

This suggests that the

immunogenicity of the vaccine may be improved with viral
suppression on ART.
 a risk factor
for morbidity and mortality caused by a number of infections that can
usually be prevented by immunization.

• There are some guidelines for influenza vaccination on PLHIV

• The inactivated vaccine formulation is recommended for the 2016-2017

influenza season;
• The specific schedule and inactivated vaccine components are the same
as for the general population and are discussed elsewhere.

, a poor vaccine response can be expected in patients

with HIV, particularly those with advanced disease.