Human immunodeficiency virus type 1 infection despite prior immunization with a recombinant envelope vaccine regimen.
With efforts underway to develop a preventive human immunodeficiency virus type 1 (HIV-1) vaccine, it remains unclear which immune responses are sufficient to protect against infection and whether prior HIV-1 immunity can alter the subsequent course of HIV-1 infection. We investigated these issues in the context of a volunteer who received six HIV-1LAI envelope immunizations and 10 weeks thereafter acquired HIV-1 infection through a high-risk sexual exposure. In contrast to nonvaccinated acutely infected individuals, anamnestic HIV-1-specific B- and T-cell responses appeared within 3 weeks in this individual, and neutralizing antibody preceded CD8+ cytotoxic responses. Despite an asymptomatic course and an initial low level of detectable infectious virus, a progressive CD4+ cell decline and dysfunction occurred within 2 years. Although vaccination elicited immunity to HIV-1 envelope, which was recalled upon HIV-1 exposure, it was insufficient to prevent infection and subsequent immunodeficiency.
McElrath
M J
MJ
Department of Medicine, University of Washington School of Medicine, Seattle 98195, USA.
Corey
L
L
Greenberg
P D
PD
Matthews
T J
TJ
Montefiori
D C
DC
Rowen
L
L
Hood
L
L
Mullins
J I
JI
D016915:AIDS Vaccines; D000328:Adult; D000595:Amino Acid Sequence; D001402:B-Lymphocytes / Q000276:immunology; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D015686:Gene Products, env / Q000096:biosynthesis / Q000737:chemistry / Q000276:immunology*; D015483:HIV Antibodies / Q000097:blood*; D019302:HIV Envelope Protein gp160; D015658:HIV Infections / Q000276:immunology*; D006679:HIV Seropositivity; D015497:HIV-1; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008969:Molecular Sequence Data; D011498:Protein Precursors / Q000276:immunology; D012309:Risk-Taking; D012900:Smallpox Vaccine; D013601:T-Lymphocytes / Q000276:immunology; D013997:Time Factors; D014614:Vaccines, Synthetic
D016915:AIDS Vaccines; D015686:Gene Products, env; D015483:HIV Antibodies; D019302:HIV Envelope Protein gp160; D011498:Protein Precursors; D012900:Smallpox Vaccine; D014614:Vaccines, Synthetic