Sansonetti, Paola and Sali, Michela and Fabbiani, Massimiliano and Morandi, Matteo and Martucci, Rosa and Danesh, Ali and Delogu, Giovanni and Bermejo Martín, Jesús F. and Sanguinetti, Maurizio and Kelvin, David J. and Cauda, Roberto and Fadda, Giovanni and Rubino, Salvatore (2014) Immune response to influenza A(H1N1)v in HIV-infected patients. The Journal of Infection in Developing Countries, Vol. 8 (1), p. 101-109. ISSN 2036-6590. eISSN 1972-2680. Article.
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Introduction: HIV infection is considered a risk factor for severe outcomes of influenza A(H1N1)v infection. However, data on immune response against influenza A(H1N1)v virus in HIV-infected patients are lacking.
Methodology: Data from seven HIV-positive and 14 HIV-negative patients infected with A(H1N1)v and from 23 HIV-positive and six HIV-negative asymptomatic controls were analyzed to evaluate the clinical picture, A(H1N1)v viral shedding, and the immune response against the virus.
Results: Patients displayed mainly upper respiratory tract diseases (57.1%), while pneumonia was diagnosed only in HIV-negative patients (23.8% of subjects, of which 4.8% required intensive care unit admission). At day seven, 29% of HIV-infected patients were still positive for A(H1N1)v by RT-PCR on nasopharyngeal swabs. Interestingly, a persistence of CXCL10 secretion at high level and lower IL-6 levels was observed in HIV-positive subjects. The geometric mean haemagglutination inhibition titer (HI-GMT) and anti-influenza IgM levels were lower in HIV-positive individuals while anti-influenza IgG levels remained similar in the two groups.
Conclusions: The immune impairment due to HIV infection could affect A(H1N1)v clearance and could lead to a lower antibody response and a persistent secretion of CXCL10 at high levels. However, the lower IL-6 secretion and treatment with highly active antiretroviral therapy (HAART) could result in a milder clinical picture.
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