Dr. Holodniy,

If the 'flu vaccine is given and CD4 cells tested 10-14 days later, would you expect the vaccine to result in an increase or decrease in CD4 numbers and CD4/CD8 ratio?

Have studies been done on the effect on T cell numbers at different times after 'flu vaccination? For example, could the initial (first week) reaction to the vaccine be an increase in CD4 cells and, due to an increased viral load from the vaccine, fewer CD4 cells a week or two after that? Also, would the effect on CD4 cells be different for HIV positive folks versus HIV negative? (in that the vaccine would also cause an increase in viral load and result in fewer CD4 cells for HIV positive people, whereas for HIV negative folk, the vaccine would just trigger an immune response, including an increase in CD4 numbers?).

I would greatly appreciate your clarifying this for me.

Many thanks. Happy holidays!

The published data in HIV infected patients around this issue is conflicting. Some studies show increases and others show decreases. This probably relates to the different populations and timing of samples. The change in CD4 count and viral loads with a real influenza infection or vaccine are dependent on what someones CD4 count and viral load is, whether they are on HIV treatment. There is very little data on uninfected people and CD4 counts.