RESUMO
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.
RESUMO
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.
Assuntos
Linfócitos B/imunologia , Infecções por HIV/imunologia , Vacinas contra Influenza/efeitos adversos , Linfócitos B/efeitos dos fármacos , Contagem de Linfócito CD4 , HIV/genética , HIV/isolamento & purificação , Soronegatividade para HIV , Soropositividade para HIV/imunologia , Humanos , Hospedeiro Imunocomprometido , Vacinas contra Influenza/administração & dosagem , Injeções Intramusculares , Cinética , Contagem de Linfócitos , RNA Viral/sangue , RNA Viral/isolamento & purificação , Linfócitos T/imunologia , Carga ViralRESUMO
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.
