Track topics on Twitter Track topics that are important to you
This 2-part study will examine 1) the immune response to influenza (flu) vaccine in HIV-infected patients, and 2) the effect of flu vaccine on HIV viral loads. Earlier studies have shown that people with HIV infection do not respond as well to flu vaccine as healthy subjects; that is, they don't make as many antibodies in response to the vaccine. Also, studies done before the use of HAART (highly active antiretroviral treatment) have shown that HIV levels increase for a period of time after flu vaccination. One small study showed a small brief increase in HIV even in patients taking HAART. The current trial will examine whether the flu vaccine does, in fact, cause an elevation in viral load and whether this increase is harmful or indicates a better response to the vaccine.
HIV-infected patients and healthy normal volunteers between 18 and 60 years of age may be eligible for part1of this study. (Healthy volunteers will serve as control subjects to make sure the flu vaccine stimulates production of enough antibody to protect against the flu). Part 2 will include only HIV-infected patients with fewer than 50 copies per milliliter of HIV. Patients in both parts of the study must have been receiving HAART (consisting of at least two nucleoside reverse transcriptase inhibitors plus a non-nucleoside reverse transcriptase inhibitor or a protease inhibitor) for at least 3 months before enrollment in the study. Candidates will be screened with a medical history and blood tests, including HLA testing (a genetic test of immune system markers). Women who are able to have children will have a pregnancy test. Pregnant women are excluded from the study.
Participants will undergo the following procedures:
- Part 1 - Immune Response to Flu Vaccine
In the first of two visits, participants will have blood drawn for flu antibody levels before vaccination and, in HIV-infected patients, measures of T cell count and viral load. They will then receive the flu vaccine. Blood will be drawn at a second visit 28 days later for the same tests.
- Part 2 - Effect of Flu Vaccine on Viral Levels
Participants will be randomly assigned to receive the flu vaccine either at the beginning of their enrollment in the study (immediate) or 3 weeks after enrollment (deferred). Those in the immediate group receive the flu vaccine on the first day (day 0) and have blood drawn on days 0, 3, 7, 10, 14, 17, 21, 24, 28, 31, 35, 38 and 42. Those in the deferred group are vaccinated on day 21 and have blood drawn on days 0, 3, 7, 10, 14, 17, 21, 24, 28, 31, 35, 38, 42 and 49. The blood is tested for viral load, CD4 cell counts and antibody levels.
This two-part protocol will evaluate: Part 1: the response to influenza vaccine in HIV-infected adults receiving highly active antiretroviral therapy (HAART); and Part 2: the effect of influenza vaccine on HIV-viral load (Part 2). The purpose of Part 1 is to evaluate the effect of HIV viral load on the generation of influenza-specific antibodies. 95 HIV-infected subjects with any CD4 cell count and HIV viral load on HAART will be enrolled to receive the influenza vaccine appropriate to the on-going influenza season and to have laboratory studies (including influenza titers, CD4 counts, and HIV viral loads) obtained at baseline and 28 days post vaccination; 15 HIV-negative healthy volunteers will serve as controls to demonstrate that the vaccine preparation can induce protective immunity. The purpose of Part 2 is to assess the potential effect of vaccine-associated immune activation on HIV viral replication in 30 HIV-infected subjects on HAART who have suppressed HIV viremia (less than 50 copies/mL) at the screening visit. These subjects will be randomized to receive the influenza vaccine appropriate to the on-going influenza season immediately or 3 weeks after enrollment. Both groups will have frequent blood draws for HIV viral load with the 3 weeks immediately after vaccine serving as the vaccine response period and the other 3 weeks serving as the control period for each subject. All subjects will have pre-vaccine and 28 day post vaccine influenza titers determined to see if there is a relationship between HIV viral load increases and vaccine responses. Subjects will be compensated for participation in both parts of the study. Those subjects who are ineligible for Part 2 because their screening HIV viral loads are greater than 50 copies/mL will be invited to participate in Part 1. This study will be conducted during the USA influenza season (Oct-March). Thus, the primary study risks are those of phlebotomy and inconvenience. Although there are some risks to influenza vaccine, the ACIP recommends influenza vaccination for HIV-infected patients. Finally, for subjects deferring vaccination for three weeks, there is presumably an increased risk of developing influenza. Total enrollment of the study is 140 subjects (125 HIV-infected individuals and 15 HIV-negative controls).
National Institute of Allergy and Infectious Diseases (NIAID)
National Institutes of Health Clinical Center (CC)
Published on BioPortfolio: 2014-08-27T03:56:33-0400
Current projects study veteran patients with chronic ulcers and MRSA colonization and infection, patients with imipenem-resistant P. aeruginosa colonization and infection, the relationship...
This retrospective study aims to improve the diagnosis of PJI as well as to identify microorganisms causing periprosthetic joint infection (PJI) and the drug-resistant spectrum
This is a protocol designed to provide HAART to subjects with acute HIV infection who are enrolled in SEARCH 010 study (protocol title: Establish and characterize an acute HIV infection co...
The purpose of this study is to identify and provide immediate antiretroviral therapy to a cohort of HIV-infected individuals with "hyperacute" infection (estimated date of HIV infection w...
Recently human papillomavirus (HPV) has been recognized to cause some oropharyngeal (tonsil) cancer. But very little is known about oral HPV infection and risk factors. This study will eva...
Out of several phases of HBV infection, the least understood phase is occult hepatitis virus infection. The paucity of data due to non-availability of biological tissues and the prerequisite of ultra-...
HIV-1 dual infection is a condition that results from infection with at least two HIV-1 variants from different sources. The scarceness of information on this condition is partly due to the fact that ...
Primary human immunodeficiency virus type 1 (HIV-1) infection is defined as the period from initial infection with HIV to complete seroconversion. Neurologic sequelae of primary HIV-1 infection are no...
The 2015 APIC MegaSurvey was completed by 4,078 members to assess infection prevention practices. This study's purpose was to examine MegaSurvey results to relate infection preventionist (IP) certific...
HIV-associated motor neuron disease (MND), or amyotrophic lateral sclerosis (ALS)-like syndrome associated with HIV infection, is a rare manifestation of HIV infection. HIV-associated MND has only bee...
Infection by a variety of fungi, usually through four possible mechanisms: superficial infection producing conjunctivitis, keratitis, or lacrimal obstruction; extension of infection from neighboring structures - skin, paranasal sinuses, nasopharynx; direct introduction during surgery or accidental penetrating trauma; or via the blood or lymphatic routes in patients with underlying mycoses.
A nontuberculous infection when occurring in humans. It is characterized by pulmonary disease, lymphadenitis in children, and systemic disease in AIDS patients. Mycobacterium avium-intracellulare infection of birds and swine results in tuberculosis.
Infection involving the tissues or organs in the PELVIS.
Infection in humans and animals caused by fungi in the class Zygomycetes. It includes MUCORMYCOSIS and entomophthoramycosis. The latter is a tropical infection of subcutaneous tissue or paranasal sinuses caused by fungi in the order Entomophthorales. Phycomycosis, closely related to zygomycosis, describes infection with members of Phycomycetes, an obsolete classification.
An infection at a specific location that may spread to another region of the body.
Alternative Medicine Cleft Palate Complementary & Alternative Medicine Congenital Diseases Dentistry Ear Nose & Throat Food Safety Geriatrics Healthcare Hearing Medical Devices MRSA Muscular Dyst...