title: Immune activation and virologic response to immunization in recent HIV type 1 seroconverters.
abstract: Antigenic stimulation from invasive bacterial infections, and the vaccines designed to prevent them, may promote T cell activation and enhancement of HIV-1 replication. Changes in viral load have been correlated with antigen-specific responses. We prospectively determined the impact of immunization with 23-valent pneumococcal vaccine (PVAX) and Haemophilus influenzae type b (Hib)-modified diphtheria toxoid CRM197 (DT) vaccine on HIV-1 replication in recent HIV-1 seroconverters (n = 14; median, 5.5 months from infection; median CD4+ T cells, 535 microl), and correlated results with vaccine-related immune activation. Specific antibody responses, markers of CD4+ T cell activation (transferrin and interleukin 2 receptors), and viral burden were measured at weeks -2 (pre), 0, 1, 2, 6, and 12 after immunization. By week 2, levels of IgG had increased significantly over baseline in both HIV-1-infected patients and HIV-1-seronegative control subjects (n = 9) for each antigen (geometric mean fold rise: PVAX, 10.1 versus 5.3; Hib, 16.0 versus 11.7; and DT, 26.2 versus 24.5, respectively). Despite these vigorous responses to both polysaccharide and protein antigens, HIV-1-infected patients showed limited evidence of CD4+ T cell activation at 1 week, no consistent rise in HIV-1 burden at any point, and no decline in CD4+ T cell number over time. We conclude that recent HIV-1 seroconverters show vigorous humoral responses to vaccine antigens and limited early evidence of T cell activation, but no substantial or sustained increase in viral replication or decline in CD4+ T cell number. Thus, respiratory bacterial vaccines appear immunogenic and safe early in HIV-1 infection.
authors.affiliation: Department of Medicine, Veterans Affairs Medical Center, Minneapolis, Minnesota 55417, USA. janof001@tc.umn.edu
authors.forename: E N
authors.initials: EN
authors.lastname: Janoff
authors.forename: S A
authors.initials: SA
authors.lastname: Tasker
authors.forename: M
authors.initials: M
authors.lastname: Stevenson
authors.forename: J B
authors.initials: JB
authors.lastname: Rubins
authors.forename: J
authors.initials: J
authors.lastname: O'Brien
authors.forename: G
authors.initials: G
authors.lastname: Utz
authors.forename: P
authors.initials: P
authors.lastname: Weiss
authors.forename: F W
authors.initials: FW
authors.lastname: Hall
authors.forename: M R
authors.initials: MR
authors.lastname: Wallace
mesh_terms: D000328:Adult; D001428:Bacterial Vaccines / Q000276:immunology*; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D004168:Diphtheria Toxoid / Q000276:immunology*; D005260:Female; D006679:HIV Seropositivity / Q000097:blood / Q000276:immunology* / Q000821:virology*; D015497:HIV-1 / Q000235:genetics / Q000502:physiology*; D018073:Haemophilus Vaccines / Q000276:immunology*; D006801:Humans; D008297:Male; D010949:Plasma / Q000821:virology; D022242:Pneumococcal Vaccines; D011446:Prospective Studies; D014611:Vaccination; D018074:Vaccines, Conjugate / Q000276:immunology*; D019562:Viral Load
chemical_list: D001428:Bacterial Vaccines; D004168:Diphtheria Toxoid; D018073:Haemophilus Vaccines; C052180:Haemophilus influenzae type b-polysaccharide vaccine-diphtheria toxoid conjugate; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate