Flu vaccine to cure HIV

Does flu vaccine provide adequate and better protection for people with HIV. Yes, if the results of a study carried out in the United States is any indication.

A research study in the US has found that quadruple-dose flu vaccine for the elderly can be used for providing better protection for people with HIV.

The study was part of a programme to find out results of research involving high-dose vaccine injected into people who have compromised or reduced immune systems.

The team of researchers were from Philadelphia institutions and they are now asking a federal advisory committee in the US to recommend high-dose vaccination for HIV-positive people.

Incidentally, the Food and Drug Administration (FDA) in late 2009 had licensed Fluzone High-Dose, manufactured by Sanofi Pasteur in Swiftwater, Pa., for use in people aged 65 and older.

There was limited research on other groups, such as people with HIV.

The elderly and people with compromised immune systems account for the vast majority of the thousands of deaths from seasonal influenza in the US. Such people suffer from decreased immune levels and they are prone to severe complications. Such people also produce a weaker response to standard vaccine, making them more likely to catch flu.

The study found a higher dose of vaccine more immunogenic, and more surprisingly  the stronger immune response was found in people with HIV. This proved to be similar to that produced by older people with Fluzone High-Dose. It also matched the response in healthy younger adults to the standard vaccines.

Medical experts and researchers have been trying to devise ways to give better protection from the flu to people with HIV, cancer, rheumatoid arthritis, renal failure and other diseases wherein treatment suppresses the immune system.

The Philadelphia study was led by Noah McKittrick, then at Penn and now at Thomas Jefferson University. It involved researchers at Penn and also at Drexel University.

Under the study, 190 HIV positive adults were enrolled at Penn's MacGregor Clinic during the 2010-11 flu season. The trials were conducted between October 27, 2010 to  March 27, 2011. Half the enrolled  got a high dose (60mcg); the other half the standard version of Fluzone (15 mcg of antigen per strain).

The high-dose group produced more antibodies than the standard group against all three influenza. Both groups had started the season with relatively high levels of protection.

More than 90 per cent of  high-dose group produced immune responses considered protective against each of the three strains. No serious adverse events or side effects were reported. An increase in minor reactions, such as pain at the injection site, was similar to that seen in the elderly.

Now the question is whether the vaccine will actually prevent the flu. This study actually measured the level of antibodies to protect against the flu - not the flu itself- and therefore studies on prevention would require more studies.

What were the actual results of the study.

In all, 195 participants had enrolled and of them 190 completed the study (93 in the standard-dose group and 97 in the high-dose group).

The seroprotection rates after vaccination were higher in the high-dose group for the H1N1 (96 per cent versus 87 percent treatment difference, 9 percentage points [95 per cent CI, 1 to 17 percentage points]; P = 0.029), H3N2 (96 per cent versus 92 per cent treatment difference, 3 percentage points [CI, -3 to 10 percentage points]; P = 0.32), and influenza B (91 per cent vs. 80 per cent  treatment difference, 11 percentage points [CI, 1 to 21 percentage points]; P = 0.030) strains. Both vaccines were well-tolerated, with myalgia (19 per cent), malaise (14 per cent, and local pain (10 per cent) the most frequent adverse events.

The main limitation of the study was that the effectiveness of the vaccine in preventing clinical influenza was not evaluated. The number of participants with CD4 counts less than 0.200 × 109 cells/L was also limited.

Moreover, the objective of the study was to compare the immunogenicity of high-dose influenza vaccine with that of standard dosing in HIV-positive participants and the participants included those over 18 year of age who were HIV infected.

An institute for AIDS research

India is one of the countries world that is affected by HIV/AIDS. Though recent surveys have indicted that the number of HIV/AIDS cases have come down, the country is still home to millions of people suffering from this pandemic.

While there is enough literature on HIV/AIDS and also a variety of treatments available, a common man still harbours a great deal of misconceptions about it. Similarly, very few are also aware that there is a research institute that is exclusively devoted to research on HIV/AIDS and that it has been doing yeomen service since its inception.

This is the National AIDS Research Institute (NARI), which was established in October 1992 in Bhosari, Pune on a seven acre plot.

An Institute devoted exclusively to HIV/ AIDS that could undertake research of such a diversity and magnitude was established to meet this requirement.

Over the years the institute has expanded its activities in various aspects of research on HIV and AIDS and also collaborated with other national and international agencies and organizations in the field.

The activities of NARI are supported by the Indian Council of Medical Research and other agencies. Its research activities are guided by a scientific advisory committee which comprises among others of eminent scientists from different disciplines.

Because of the sensitive nature of research and ethics, all research projects are reviewed and approved by the Ethics Committee which ensures that any research is conducted with highest ethical standards.

The main objective of the institute is to control spread of  HIV and to provide care to HIV infected population. The care includes  treatment and vaccine. NARI itself runs seven clinics in different parts of  Pune city which provides varied services such as voluntary counseling, testing centers and care and support.

The institute has eight divisions, including Epidemiology and Biostatistics, Serology and Immunology, Clinical Sciences, Molecular Virology, Microbiology, Behavioral and Social Sciences, Library and Documentation and Administration.

Currently NARI has a permanent staff strength of 60 with additional personnel for specific projects.

It collaborates with Johns Hopkins University, USA, National Institute of Allergy and Infectious Disease ,USA, International AIDS Vaccine Initiative and Family Health International. At the national level, the institute has a sound working collaboration with National AIDS Control Organization, New Delhi and Department of Biotechnology, New Delhi.

NARI has set up a cohort of HIV seronegative persons so that it can collect information on the spread of HIV, the rate of infection and role of other diseases such as herpes simplex, virus 2 and syphilis. 

NARI also has the distinction of  having conducted India's first HIV vaccine trial. It also carried out clinical trials for anti-HIV drugs under international regulatory requirements. The institute has a separate center for carrying this trial which  provides treatment to HIV infected through National ARV roll out programme.

The institute has also taken up studies on what it calls women controlled methods for prevention of HIV.

Apart from NARI, there are several other institutes that are currently engaged in research on HIV/AIDs and its prevention and cure.