Editorial Response: Influenza, Influenza Virus Vaccine, and Human Immunodeficiency Virus Infection

In 1992, a study appeared in the medical literature that found are generally detected in humans about 7–10 days after vacci-nation. If individuals have HIV infection, increases in bloodan increase in the level of HIV RNA in the blood of HIV-HIV RNA levels might be expected 2 or 3 days thereafter.infected patients after they had received inactivated influenza Most, but not all, reported increases in viral RNA levels oc-virus vaccine [1]. Because it was becoming increasingly clear curred 7 or 14 days after vaccination, and a rise was moreat the time that the level of HIV RNA (commonly called viral likely to be detected in persons who had higher CD4 cell countsload) in blood correlates with the rate of progression of HIV-and exhibited lymphocyte proliferative responses or antibodyinduced disease, concern for routinely employing this public formation [1, 3–12]. Thus, most increased HIV RNA levels dohealth procedure began. Since that time, a number of studies so in a pattern that would be expected from our understandinghave been reported in which a similar increase in HIV load of immunologic responsiveness and HIV infection. Failure towas detected, and a number of investigations (including the detect an increase (as in the report by Fuller et al. [2]) couldone by Fuller et al. [2] in the present issue of CID) have been represent sampling time, presence of a sufficient number ofreported in which no such increase was detected [3–12]. Thus, responsive lymphocytes, suppression of responses in immunethere are conflicting findings in regard to the occurrence of an persons, coexisting disease, coexisting chemotherapy, or an-increase in viral load following administration of influenza other variable.virus vaccine to HIV-infected patients