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The U.S. response to the Ebola epidemic resulted in many federal agencies assessing their ability to respond to global threats and improve the efficiency of humanitarian efforts.
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BACKGROUND: Yearly influenza vaccination, although recommended for human immunodeficiency virus (HIV)-infected individuals, has not received thorough evaluation in the era of antiretroviral therapy. We assessed the impact of HIV disease on B cell responses to influenza vaccination. METHODS: Sixty-four HIV-infected and 17 HIV-negative individuals received the 2003-2004 trivalent inactivated influenza vaccine. Frequencies of influenza-specific antibody-secreting cells (ASCs) were measured by enzyme-linked immunospot (ELISPOT) assay, and antibody responses were measured by hemagglutination-inhibition (HI) assay. Memory responses to influenza were measured by ELISPOT assay after polyclonal activation of B cells in vitro. RESULTS: Prevaccination HI titers were significantly higher in HIV-negative than in HIV-infected individuals. Peak HI titers and influenza-specific ASC frequencies were directly correlated with CD4+ T cell counts in HIV-infected individuals. Influenza-specific memory B cell responses were significantly lower in HIV-infected than in HIV-negative individuals and were directly correlated with CD4+ T cell counts. CONCLUSIONS: HIV infection is associated with a weak antibody response to influenza vaccination that is compounded by a poor memory B cell response. CD4+ T cell count is a critical determinant of responsiveness to influenza vaccination, and the contribution of plasma HIV RNA level is suggestive and warrants further investigation.
Asunto(s)
Linfocitos B/inmunología , Infecciones por VIH/inmunología , Vacunas contra la Influenza/efectos adversos , Linfocitos B/efectos de los fármacos , Recuento de Linfocito CD4 , VIH/genética , VIH/aislamiento & purificación , Seronegatividad para VIH , Seropositividad para VIH/inmunología , Humanos , Huésped Inmunocomprometido , Vacunas contra la Influenza/administración & dosificación , Inyecciones Intramusculares , Cinética , Recuento de Linfocitos , ARN Viral/sangre , ARN Viral/aislamiento & purificación , Linfocitos T/inmunología , Carga ViralRESUMEN
The U.S. uniformed services frequently respond to natural and man-made disasters worldwide. Disaster management and humanitarian assistance has been a major focus of military medicine for well over a decade. Training for these missions is a priority for the U.S. military, specifically as a result of the Gulf War. The Medical Humanitarian Assistance Course for advanced practice nurses is a course available to train advanced practice nurses in disaster management and humanitarian assistance. This article will describe the evolution, design, format, and implementation of the Medical Humanitarian Assistance Course.