title: Long-term persistence of vaccination and HAART to human immunodeficiency virus (HIV).
abstract: The aim of this study was to monitor the immune responses in HIV-infected patients previously immunized with gp160 or DNA vaccines to analyze whether the introduction of highly active antiretroviral treatment (HAART) would affect the persistence of immunity. The immune responses were evaluated in patients who had participated in randomized trials of therapeutic vaccination. Immunization in conjunction with antiretroviral therapy was effective in inducing HIV-specific T-cell responses. Therapeutic immunizations with recombinant gp160 had a modest effect on CD4-cell counts, the treatment alone lead to a transient clinical benefit in the form of an improved survival after two years of immunization. Immunizations with HIV DNA during HAART treatment permitted persistence or development of innate (NK), CD4+ and/or CD8+ immune responses. HIV specific T-helper cell responses induced by immunization with gp160 were maintained at high levels up to 7 years after the last injection. Cells with HIV-specific interferon-gamma (IFN-gamma) production were retained or increased in long-term HAART treated patients. The impact of a single structured therapy interruption (STI) was analyzed in a small group of patients showing no obvious increase or decrease in the HIV-specific immune response during or after STI. The possibility to induce very long-term strong and persistent immune responses in HIV-infected individuals raises hopes that vaccination preceding therapy interruption might prolong the symptom-free period without HAART.
authors.affiliation: Department of Virology, Swedish Institute for Infectious Disease Control, Microbiology and Tumor Biology Center, Karolinska Institutet, Stockholm 171 82, Sweden.
authors.forename: Ann-Charlotte
authors.initials: AC
authors.lastname: Boström
authors.forename: Bo
authors.initials: B
authors.lastname: Hejdeman
authors.forename: Reikei
authors.initials: R
authors.lastname: Matsuda
authors.forename: Malin
authors.initials: M
authors.lastname: Fredriksson
authors.forename: Eva-Lena
authors.initials: EL
authors.lastname: Fredriksson
authors.forename: Göran
authors.initials: G
authors.lastname: Bratt
authors.forename: Eric
authors.initials: E
authors.lastname: Sandström
authors.forename: Britta
authors.initials: B
authors.lastname: Wahren
mesh_terms: D016915:AIDS Vaccines / Q000627:therapeutic use*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D015483:HIV Antibodies / Q000096:biosynthesis; D019302:HIV Envelope Protein gp160 / Q000276:immunology; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology / Q000628:therapy*; D015497:HIV-1 / Q000276:immunology; D006801:Humans; D007114:Immunization; D007167:Immunotherapy; D011994:Recombinant Proteins / Q000276:immunology; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology; D019444:Vaccines, DNA / Q000276:immunology
chemical_list: D016915:AIDS Vaccines; D015483:HIV Antibodies; D019302:HIV Envelope Protein gp160; D011994:Recombinant Proteins; D019444:Vaccines, DNA