FluAGE study supports BHIVA recommendations for HIV positive people to have annual flu shot

Simon Collins, HIV i-Base

Results from a UK study found that immune responses to influenza vaccination were similar for both HIV positive men on ART and healthcare workers used as a control group. This supports the British HIV Association (BHIVA) recommendation for HIV positive people to routinely have this annual vaccination.

The FluAGE study was led by Dr Katrina Pollock with colleagues from Imperial College London and the finding were published in Scientific Reports in October.

The group were able to identify distinct CD4 T cell subsets that generated immune responses to the 2017/18 inactivated quadrivalent influenza vaccine recommended by BHIVA.

The study included 16 HIV positive men – 8 who started ART during acute infection and 8 who started in chronic infection and 14 sex-matched health workers in the control group.

The median CD4 count at vaccination was 789 cells/mm3 (IQR: 665 to 1033) vs 609 cells/mm3 (IQR: 454 to 931) in the ART acute vs chronic groups respectively. Median CD4 nadir was 522 cells/mm3 (IQR: 466 to 734) vs 170 cells/mm3 (IQRL 80 to 410) in the two groups.

Despite the lower CD4 nadir in people who started ART during chronic infections, there were no differences in vaccine responses between the three groups. Functional immune recovery reflected in humoral and cellular responses were all similar to controls.

The researchers concluded that these data support the BHIVA recommendations that all HIV positive people be offered a vaccine containing four different types of flu (two A-strains and two B-strains). They also provide evidence that the immune system can function normally in response to vaccination, when HIV is treated and viral load is suppressed.


Cole M et al. Responses to quadrivalent influenza vaccine reveal distinct circulating CD4+CXCR5+ T cell subsets in men living with HIV. Scientific Reports. DOI: 10.1038/s41598-019-51961-9,

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