Antiretroviral therapy interruptions result in loss of protective humoral immunity to neoantigens in HIV-infected individuals.

نویسندگان

  • Livio Azzoni
  • Andrea S Foulkes
  • Cynthia Firnhaber
  • Xiangfan Yin
  • Zhi Q Xiang
  • Yan Li
  • Wendy Stevens
  • Robert Gross
  • Hildegund C J Ertl
  • Ian Sanne
  • Luis J Montaner
چکیده

OBJECTIVE Sustained antiretroviral therapy (ART)-mediated viral suppression restores responses to vaccination in HIV-1-infected individuals. As ART interruption occur frequently in resource-constrained settings, we studied their effects on the ability to mount humoral immune responses against a neoantigen. DESIGN Treatment-naive HIV-1-infected individuals were treated with stavudine, lamuvidine and lopinavir/ritonovir. Individuals who maintained viral load less than 50  copies/ml and CD4 T-cell counts more than 450  cells/μl for 6 months received three doses of rabies vaccine, and were randomized to 72 weeks of continuous ART (arm 1) or sequential 2, 4 and 8-week ART interruptions (arm 2). An additional vaccine dose was administered at study end. METHODS Neutralizing antibody titers to rabies virus were assessed in plasma with a rapid fluorescent focus-inhibiting test. RESULTS The proportion of participants achieving protective (>0.5 IU/ml) antibody titer after vaccination was similar (arm 1=92%; arm 2=91%), but over time the cumulative proportion of observations with protective titer was greater in arm 1 than arm 2 (P=0.0177). From week 26 after vaccination, antibody titers were lower in arm 2 than arm 1, and volunteers in arm 2 lost protective antibody titers at a greater rate (P=0.0029). After boosting, 100% of arm 1 and 95% arm 2 volunteers achieved protective antibody titer. CONCLUSION Our data indicate that individuals undergoing recurring ART interruption retain lower neutralizing antibody titers to a neoantigen, but maintain the ability to mount secondary responses upon boosting, suggesting that they might benefit from vaccine schedule intensification.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Clinical and Para Clinical Manifestations of HIV-Positive Patients at Different Levels of CD4

Background and Objective: Human immunodeficiency virus (HIV)-infected people are at higher risk of opportunistic infections due to immunodeficiency. The current study aimed to evaluate the different levels of CD4 in HIV-infected patients and its relationship with clinical and paraclinical manifestations of the patients. Materials and Methods: This cross-sectional study was conducted on 94 HIV-...

متن کامل

Metabolic Abnormalities in HIV-Positive Patients Receiving Highly Active Antiretroviral Therapy

Background and Objective: Dyslipidemia has become a common problem in human immunodeficiency virus (HIV) disease, especially in patients on combination antiretroviral therapy. In this study we aimed to determine the prevalence of dyslipidemia and metabolic abnormalities in 2 groups of HIV infected patients receiving highly activ...

متن کامل

Cytomegalovirus Active Infection in Persons Infected with Human Immunodeficiency Virus

Background and Objective: Cytomegalovirus (CMV), one of the most common opportunistic pathogens in patients infected with human immunodeficiency virus (HIV), can cause the diseases such as encephalitis, pneumonia, and chorioretinitis. This study aimed at molecular studying of CMV infection in individuals infected with the human immunodeficiency virus. Material and Methods: In this study, 50 ven...

متن کامل

Prospective and Retrospective Memory Complaints in HIV-Infected Individuals

Background and purpose: Deficits of retrospective memory (RetM) and prospective memory (ProM), which are two primary components of episodic memory, have been reported in prior studies in HIV-infected individuals. The present study aimed to further elucidate the characteristics of prospective and retrospective memory complaints in HIV-infected individuals. Materials and Methods: We recruited 50...

متن کامل

Immune Response to Standard Hepatitis B Vaccination in HIV-Infected Patients

Background: Due to their similar routes of transmission, human immunodeficiency virus (HIV) and hepatitis B virus (HBV) co-infection occurs considerably. HBV infection progresses more rapidly in HIV-infected patients. Therefore, HBV vaccination of all non-immune HIV infected patients is recommended. On the other hand, HIV-infected subjects have suboptimal responses to HBV vaccine. In this study...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • AIDS

دوره 26 11  شماره 

صفحات  -

تاریخ انتشار 2012