Impact of influenza and pneumococcal vaccines on inflammatory response during suppressive antiretroviral therapy.

In 30 seconds

This secondary analysis of a prospective, randomized, double-blinded, placebo-controlled crossover trial examined inflammatory responses to influenza and pneumococcal vaccination in people with HIV receiving suppressive antiretroviral therapy. Fifty-three participants contributed at least one postvaccination visit. No distinct overall cytokine profile emerged by vaccine type or placebo. Compared with placebo, pneumococcal vaccination was associated with transient increases in LBP (0.231; 95% CI: [0.126, 0.336]; P = 0.0003) and C-reactive protein (0.643; 95% CI: [0.482, 0.804]; P < 0.0001); influenza vaccination was associated with a modest decrease in RANTES (-0.116; 95% CI: [-0.188, -0.043]; P = 0.0218).

Key findings

• No distinct global cytokine profile was observed by vaccine type or placebo.
• Pneumococcal vaccination transiently increased LBP (0.231; 95% CI: [0.126, 0.336]; P = 0.0003) and C-reactive protein (0.643; 95% CI: [0.482, 0.804]; P < 0.0001) versus placebo.
• Influenza vaccination was associated with a modest RANTES decrease (-0.116; 95% CI: [-0.188, -0.043]; P = 0.0218) versus placebo.
• HIV DNA Gag levels were inversely associated with IL-16 and RANTES, independent of vaccine type.

Why it matters

The findings characterize inflammatory responses to routine vaccination in people with HIV on suppressive ART. The absence of broad cytokine perturbations, alongside mild and transient changes in individual markers, is relevant when considering vaccine-associated inflammation in this population. Associations between cytokines and HIV DNA measures also identify relationships that may warrant further study, without establishing a causal role in reservoir dynamics.

What to keep in mind

This was a secondary analysis, and only 53 participants contributed at least one postvaccination visit; the reported cytokine changes were transient.