title: Evaluation of VZV-specific cell-mediated immunity in adults infected with HIV-1 by using a simple IFN-γ release assay.
abstract: The development of herpes zoster is associated with reduced varicella zoster virus (VZV)-specific cell-mediated immune (CMI) reactions. In this study, VZV-specific CMI reactions in 42 anti-VZV-IgG antibody-positive adults infected with HIV-1 were evaluated by measuring the IFN-γ production levels in whole blood in response to stimulation with ultraviolet light-inactivated live attenuated VZV vaccine. The median VZV-specific IFN-γ production level in all patients was 63 pg/ml. Antiretroviral therapy (ART)-naïve patients with an AIDS-defining illness (HIV classification category C) had significantly lower IFN-γ production than ART-naïve patients in categories A and B and patients receiving ART (P=0.0194 and P=0.0046, respectively). IFN-γ production increased significantly in patients within 1 month of the onset of recurrent VZV disease and at more than 1 year from onset, compared with patients who had never had recurrent VZV disease (P=0.0396 and P=0.0484, respectively). In multivariate analyses, category C and history of recurrent VZV disease were significant factors affecting IFN-γ production. Levels of IFN-γ were measured before and after ART in seven ART-naïve patients with no history of recurrent VZV disease, and no significant changes were observed. The results indicate that VZV-specific CMI reactions were reduced in patients with an AIDS-defining illness and enhanced in patients with a history of recurrent VZV disease, but not enhanced by ART alone. Vaccination may be necessary to inhibit the development of herpes zoster in patients receiving ART; this IFN-γ releasing assay is one useful method for evaluating VZV-specific CMI reactions in clinical settings.
authors.affiliation: AIDS Medical Center, National Hospital Organization Osaka National Hospital, Osaka, Japan. dai@onh.go.jp
authors.forename: Dai
authors.initials: D
authors.lastname: Watanabe
authors.forename: Naruhito
authors.initials: N
authors.lastname: Otani
authors.forename: Sachiko
authors.initials: S
authors.lastname: Suzuki
authors.forename: Hiromi
authors.initials: H
authors.lastname: Dohi
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Hirota
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yonemoto
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Koizumi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Otera
authors.forename: Keishiro
authors.initials: K
authors.lastname: Yajima
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Nishida
authors.forename: Tomoko
authors.initials: T
authors.lastname: Uehira
authors.forename: Masayuki
authors.initials: M
authors.lastname: Shima
authors.forename: Takuma
authors.initials: T
authors.lastname: Shirasaka
authors.forename: Toshiomi
authors.initials: T
authors.lastname: Okuno
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification; D014645:Herpesvirus 3, Human / Q000276:immunology*; D006801:Humans; D007111:Immunity, Cellular; D059425:Interferon-gamma Release Tests / Q000379:methods*; D008297:Male; D008875:Middle Aged
chemical_list: D044966:Anti-Retroviral Agents