T-cell vaccination against anti-CD4 autoimmunity in HIV-1 infected patients.
BACKGROUND
Highly active antiretroviral therapy (HAART) is frequently associated with only partial restoration of CD4 T-cell levels. Autoimmunity to CD4 T-cells may account for the persistence of the CD4 T-cell lymphopenia in such cases.


OBJECTIVE
To document T-cell autoimmunity to CD4 in HIV-infected patients and to determine if T-cell vaccination against CD4 autoimmunity is feasible and safe.


METHODS
Seven out of 20 HIV-infected patients undergoing HAART who manifested T- cell reactivity to rCD4, gp120 and to recall antigens (Tetanus toxoid and Candida) were treated with T-cell vaccines composed of glutaraldehyde treated autologous, activated T-cells, and enriched in anti CD4-reactive T-cells. The response of the seven vaccinated patients was compared to seven non-vaccinated HIV-1 infected subjects.


RESULTS
Five out of seven responded with a decrease in anti-CD4 autoimmunity, associated with a persistent increase in their CD4 T-cell levels; just one of the control patients showed increased CD4 levels. No change in HIV plasma viral loads and no adverse effects were detected in any of the T-cell vaccinated patients.


CONCLUSIONS
The persistence of CD4 T-cell lymphopenia despite effective anti-retroviral treatment may be associated with anti-CD4 autoimmunity. T-cell vaccination with autologous autoimmune CD8 T-cells may decrease such autoimmunity and increase CD4 T-cell numbers.
Abulafia-Lapid
Rivka
R
The Human Biology Research Center, Hadassah University Hospital, Ein-Kerem, Jerusalem 91120, Israel. rivka_abulafia@yahoo.com
Bentwich
Zvi
Z
Keren-Zur
Yael
Y
Cohen
Irun R
IR
Atlan
Henri
H
D016915:AIDS Vaccines / Q000008:administration & dosage*; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D023241:Antiretroviral Therapy, Highly Active; D015551:Autoimmunity; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology* / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000276:immunology / Q000628:therapy* / Q000821:virology; D015497:HIV-1 / Q000235:genetics / Q000254:growth & development* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes / Q000276:immunology*; D016896:Treatment Outcome; D019562:Viral Load
D016915:AIDS Vaccines; D000914:Antibodies, Viral