Safety and immunogenicity of a live attenuated varicella vaccine in VZV-seropositive HIV-infected adults.
BACKGROUND
Herpes-zoster is common in HIV-infected patients in spite of antiretroviral therapy. We evaluated the safety and immunogenicity of a live attenuated varicella-zoster virus (VZV) vaccine as a candidate for protecting HIV-infected adults against herpes-zoster.


RESULTS
Sixty-seven HIV-infected and 15 uninfected subjects, 18 to 65 years old, were enrolled. Adverse events were minor and similar in HIV-infected vaccine and placebo recipients. At 12 weeks after the 2(nd) dose of vaccine the magnitude of each measure of VZV CMI increased significantly in healthy controls. In HIV-infected vaccinees, VZV RCF significantly increased and ELISPOT showed a positive trend. None of VZV CMI measures significantly increased in HIV-infected placebo recipients. The immunogenicity of the vaccine did not correlate with the nadir CD4 cells of HIV-infected subjects.


METHODS
HIV-infected adults with CD4 > or = 400 cells/microL and plasma HIV RNA <1,000/mL were randomly assigned to receive two doses of VZV vaccine or placebo 12 weeks apart. HIV-uninfected age-matched controls also received two doses of vaccine. VZV-specific cell-mediated immunity (CMI) was measured at baseline and after vaccination using responder cell frequency (RCF), lymphocyte proliferation, and IFNgamma ELISPOT.


CONCLUSIONS
Two doses of varicella vaccine were safe in HIV-infected subjects with CD4 > or = 400 cells/microL, but were only modestly immunogenic.
Weinberg
Adriana
A
University of Colorado Denver School of Medicine, Aurora, CO, USA. Adriana.Weinberg@ucdenver.edu
Levin
Myron J
MJ
Macgregor
Rob Roy
RR
D000293:Adolescent; D000328:Adult; D000368:Aged; D019433:Chickenpox Vaccine / Q000009:adverse effects* / Q000276:immunology*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006562:Herpes Zoster / Q000276:immunology* / Q000517:prevention & control*; D006801:Humans; D007111:Immunity, Cellular; D007117:Immunization, Secondary / Q000379:methods; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010919:Placebos / Q000008:administration & dosage; D014613:Vaccines, Attenuated / Q000009:adverse effects / Q000276:immunology; D055815:Young Adult
D019433:Chickenpox Vaccine; D010919:Placebos; D014613:Vaccines, Attenuated