title: Varicella-zoster virus-specific cell-mediated immune responses in HIV-infected adults.
abstract: The incidence of herpes zoster remains high in HIV-infected patients despite the use of combined antiretroviral therapy (cART). We wished to assess varicella-zoster virus (VZV)-specific cell-mediated immune (CMI) responses in HIV-infected adults on cART. VZV-specific CMI responses were assessed using lymphocyte proliferative responses, cytokine production (IL-2, TNF-α, and IFN-γ), and interferon-γ ELISPOT assays in 103 HIV-infected adults and 30 healthy controls. HIV-infected patients were analyzed according to their current and nadir CD4 cell count and their use of cART. A multivariate analysis was performed to identify factors associated with VZV-specific CMI responses. HIV-infected patients had lower VZV-specific CMI responses than healthy controls. Patients with a CD4 T cell count <100/μL had almost no detectable responses whereas those with a current CD4 T cell count >300/μL and suppressed viral replication on cART had responses similar to those of healthy controls. In multivariate analysis, factors significantly associated with VZV-specific CMI responses were the absence of a previous AIDS-defining event and higher CD4 cell counts, in particular central and effector memory CD4 T cell counts. HIV-infected patients with a history of AIDS or low CD4 cell counts have impaired VZV-specific CMI responses, and remain at risk for herpes zoster.
authors.affiliation: Department of Infectious Diseases, Hôpital Saint-Louis, Assistance-Publique Hôpitaux de Paris, University of Paris Denis Diderot, France. nathalie.de-castro@sls.aphp.fr
authors.forename: Nathalie
authors.initials: N
authors.lastname: De Castro
authors.forename: Maryvonnick
authors.initials: M
authors.lastname: Carmagnat
authors.forename: Solen
authors.initials: S
authors.lastname: Kernéis
authors.forename: Catherine
authors.initials: C
authors.lastname: Scieux
authors.forename: Claire
authors.initials: C
authors.lastname: Rabian
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Molina
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis / Q000097:blood; D000956:Antigens, Viral / Q000097:blood* / Q000276:immunology; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D060085:Coinfection; D003430:Cross-Sectional Studies; D058501:Enzyme-Linked Immunospot Assay; D005260:Female; D005434:Flow Cytometry; D006678:HIV / Q000276:immunology / Q000472:pathogenicity / Q000502:physiology; D015658:HIV Infections / Q000097:blood / Q000276:immunology* / Q000821:virology; D014645:Herpesvirus 3, Human / Q000276:immunology*; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology*; D007371:Interferon-gamma / Q000276:immunology; D007376:Interleukin-2 / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology; D014779:Virus Replication
chemical_list: D000914:Antibodies, Viral; D000956:Antigens, Viral; D007376:Interleukin-2; D012367:RNA, Viral; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma