tetano
Editor, Senior Moderator
Vaccine. 2014 Aug 12. pii: S0264-410X(14)01083-4. doi: 10.1016/j.vaccine.2014.07.101. [Epub ahead of print]
Influenza vaccination in HIV-infected individuals: Systematic review and assessment of quality of evidence related to vaccine efficacy, effectiveness and safety.
Remschmidt C1, Wichmann O2, Harder T2.
Author information
Abstract
BACKGROUND:
Influenza infection in HIV-infected individuals is associated with increased severity of illness. We performed a systematic review of the available evidence on efficacy, effectiveness and safety of seasonal influenza vaccination in HIV-infected individuals.
DESIGN:
Systematic review, meta-analysis and assessment of evidence quality.
METHODS:
Using a previous systematic review as starting point, we searched MEDLINE, EMBASE and Cochrane data base for studies on efficacy, effectiveness or safety of trivalent inactivated influenza vaccines (TIV) in HIV-infected individuals. Evidence quality was assessed for each outcome using the GRADE methodology.
RESULTS:
Three randomized-controlled trials and three cohort studies were identified, including a total of 1562 HIV-infected individuals. In adults, TIV prevented laboratory-confirmed influenza with a pooled efficacy of 85% (95% CI, 22-97%) (evidence quality: moderate), but no significant effects on other clinical outcomes were observed (evidence quality: moderate to low). One cohort study showed an effectiveness of 71% (95% CI, 44-85%) for prevention of laboratory-confirmed influenza, whereas no effect on influenza-like illness was found. However, risk of bias was high in all observational studies. In children aged 6-59 months, efficacy of TIV in preventing laboratory-confirmed influenza was 11% (95% CI, -30 to 54%) (evidence quality: moderate). Regarding other endpoints, no statistically significant effects were reported (evidence quality: moderate to low). No severe adverse events following influenza vaccination were observed in these studies.
CONCLUSION:
This systematic review indicates that TIV is effective in preventing influenza infection in HIV-infected adults but not in young children. For both age-groups, only limited evidence exists for other outcomes, indicating a need for further studies.
Copyright ? 2014. Published by Elsevier Ltd.
KEYWORDS:
Efficacy and effectiveness; Evidence quality; HIV; Influenza; Systematic review; Vaccine
PMID:
25131742
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/25131742
Influenza vaccination in HIV-infected individuals: Systematic review and assessment of quality of evidence related to vaccine efficacy, effectiveness and safety.
Remschmidt C1, Wichmann O2, Harder T2.
Author information
Abstract
BACKGROUND:
Influenza infection in HIV-infected individuals is associated with increased severity of illness. We performed a systematic review of the available evidence on efficacy, effectiveness and safety of seasonal influenza vaccination in HIV-infected individuals.
DESIGN:
Systematic review, meta-analysis and assessment of evidence quality.
METHODS:
Using a previous systematic review as starting point, we searched MEDLINE, EMBASE and Cochrane data base for studies on efficacy, effectiveness or safety of trivalent inactivated influenza vaccines (TIV) in HIV-infected individuals. Evidence quality was assessed for each outcome using the GRADE methodology.
RESULTS:
Three randomized-controlled trials and three cohort studies were identified, including a total of 1562 HIV-infected individuals. In adults, TIV prevented laboratory-confirmed influenza with a pooled efficacy of 85% (95% CI, 22-97%) (evidence quality: moderate), but no significant effects on other clinical outcomes were observed (evidence quality: moderate to low). One cohort study showed an effectiveness of 71% (95% CI, 44-85%) for prevention of laboratory-confirmed influenza, whereas no effect on influenza-like illness was found. However, risk of bias was high in all observational studies. In children aged 6-59 months, efficacy of TIV in preventing laboratory-confirmed influenza was 11% (95% CI, -30 to 54%) (evidence quality: moderate). Regarding other endpoints, no statistically significant effects were reported (evidence quality: moderate to low). No severe adverse events following influenza vaccination were observed in these studies.
CONCLUSION:
This systematic review indicates that TIV is effective in preventing influenza infection in HIV-infected adults but not in young children. For both age-groups, only limited evidence exists for other outcomes, indicating a need for further studies.
Copyright ? 2014. Published by Elsevier Ltd.
KEYWORDS:
Efficacy and effectiveness; Evidence quality; HIV; Influenza; Systematic review; Vaccine
PMID:
25131742
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/25131742