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. 2020 Sep 3;46(9):299-304.
doi: 10.14745/ccdr.v46i09a08.

Summary of the NACI systematic review and recommendation on the use of live attenuated influenza vaccine (LAIV) in HIV-infected individuals

Dorothy Moore  1   2 , Ian Gemmill  3   4 , Robyn Harrison  5   6
Affiliations

Summary of the NACI systematic review and recommendation on the use of live attenuated influenza vaccine (LAIV) in HIV-infected individuals

Dorothy Moore et al. Can Commun Dis Rep. .

Abstract

Background: Annual influenza vaccination is recommended for all individuals six months of age and older, including those with HIV infection. Prior to this statement, the National Advisory Committee on Immunization (NACI) stated that live attenuated influenza vaccine (LAIV) was contraindicated for all individuals with HIV infection. The objective of this article is to update NACI's guidance on the use of LAIV for HIV-infected individuals.

Methods: A systematic literature review of the use of LAIV in individuals with HIV was undertaken. The Canadian Adverse Events Following Immunization Surveillance System was searched for reports of adverse events following vaccination with LAIV in HIV-infected individuals. NACI approved the revised recommendations.

Results: NACI concluded that LAIV is immunogenic in children with HIV, and available data suggest that it is safe, although data were insufficient to detect possible uncommon adverse effects. LAIV may be considered as an option for vaccination of children 2-17 years old who meet the following criteria: 1) receiving highly active antiretroviral therapy for at least four months; 2) CD4 count of 500/µL or greater if age 2-5 years, or of 200/µL or greater if age 6-17 years; and 3) HIV plasma RNA less than 10,000 copies/mL. LAIV remains contraindicated for adults with HIV because of insufficient data. Intramuscular influenza vaccination is considered the standard for children living with HIV by NACI and the Canadian Paediatric & Perinatal HIV/AIDS Research Group, particularly for those without HIV viral load suppression (i.e. plasma HIV RNA is 40 copies/mL or greater). However, if intramuscular (IM) vaccination is not accepted by the patient or substitute decision-maker, LAIV would be reasonable for children meeting the criteria listed above.

Conclusion: LAIV may be considered as an option for annual vaccination of selected children with HIV.

Keywords: : National Advisory Committee on Immunization; HIV; NACI; literature review; live attenuated influenza vaccine.

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Conflict of interest statement

Competing interests: None.

Figures

Figure 1
Figure 1
Flow diagram of the study selection process for the systematic review on the efficacy, effectiveness, immunogenicity and safety of live attenuated influenza vaccine in HIV-infected individuals Abbreviation: RCT, randomized controlled trial
See this image and copyright information in PMC

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