Efficacy of granulocyte-macrophage colony-stimulating factor (GM-CSF) as a vaccine adjuvant for hepatitis B virus in patients with HIV infection.
Recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) is a cytokine with a potential vaccine adjuvant activity. It is also known that human immunodeficiency virus (HIV) infected patients often show poor immunologic responses to immunization. We examined whether the use of GM-CSF could augment the immunologic response to recombinant vaccine against the hepatitis B virus (HBV) in 80 HIV infected patients (18-35 years old). They received a double dose (40 microg) of recombinant HBV vaccine IM at 0, 1 and 6 months and were randomized to receive either concurrent 20 microg of GM-CSF (n=40) or placebo IM (n=40) with the first vaccine dose. A significant increase in the seroconversion rate was observed after the second vaccine dose in the GM-CSF group (62% GM-CSF versus 30% control group P<0.0074). The average anti-HBs titers measured on days 28, 60 and 210 were 40.3; 366.5 and 644.8 milli-international units per milliliter (mIU/ml), respectively, in the GM-CSF group, and 62.4; 166.4 and 375.0 mIU/ml, respectively, in the control group, with significant differences at 60 and 210 days (P<0.01). There were no significant differences between CD4/CD8 cells, viral load, risk factors, age, sex and the serological responses to the HBV vaccine. This study suggests that GM-CSF increases the immunogenicity of recombinant HBV vaccine in HIV infected individuals.
Department of Infectious Diseases, Hospital de Cli;nicas, Universidade Federal do Paraná, Rua Euclides da Cunha, 1560/123 Bigorrilho, Curitiba-Paraná 80730-360, Curitiba, Brazil. graca.sasaki@uol.com.br
Maria das Graças
Md
Sasaki
Roberto
R
Foccacia
Iara J
IJ
de Messias-Reason
D000276:Adjuvants, Immunologic / Q000494:pharmacology*; D000293:Adolescent; D000328:Adult; D018592:Cross-Over Studies; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000494:pharmacology*; D015658:HIV Infections / Q000150:complications* / Q000276:immunology; D006508:Hepatitis Antibodies / Q000032:analysis / Q000096:biosynthesis; D017325:Hepatitis B Vaccines / Q000009:adverse effects / Q000276:immunology*; D006515:Hepatitis B virus / Q000276:immunology*; D006801:Humans; D008297:Male; D014614:Vaccines, Synthetic / Q000276:immunology
D000276:Adjuvants, Immunologic; D006508:Hepatitis Antibodies; D017325:Hepatitis B Vaccines; D014614:Vaccines, Synthetic; D016178:Granulocyte-Macrophage Colony-Stimulating Factor