학술논문

Loss of Preexisting Immunological Memory Among Human Immunodeficiency Virus–Infected Women Despite Immune Reconstitution With Antiretroviral Therapy
Document Type
article
Source
The Journal of Infectious Diseases. 222(2)
Subject
Medical Microbiology
Biomedical and Clinical Sciences
Immunology
Emerging Infectious Diseases
Vaccine Related
Prevention
HIV/AIDS
Infectious Diseases
Sexually Transmitted Infections
Rare Diseases
Immunization
Clinical Research
Immunotherapy
Pediatric
Infection
Inflammatory and immune system
Good Health and Well Being
Adult
Anti-HIV Agents
Antibodies
Viral
CD3 Complex
CD4-Positive T-Lymphocytes
CD8-Positive T-Lymphocytes
Cohort Studies
Female
HIV Infections
Humans
Immune Reconstitution
Immunologic Memory
Lymphocyte Activation
Smallpox Vaccine
Time Factors
Vaccinia virus
HIV
ART
antiretroviral therapy
smallpox
vaccination
immunological memory
Biological Sciences
Medical and Health Sciences
Microbiology
Biological sciences
Biomedical and clinical sciences
Health sciences
Language
Abstract
BackgroundIt is unclear whether human immunodeficiency virus (HIV) infection results in permanent loss of T-cell memory or if it affects preexisting antibodies to childhood vaccinations or infections.MethodsWe conducted a matched cohort study involving 50 pairs of HIV-infected and HIV-uninfected women. Total memory T-cell responses were measured after anti-CD3 or vaccinia virus (VV) stimulation to measure T cells elicited after childhood smallpox vaccination. VV-specific antibodies were measured by means of enzyme-linked immunosorbent assay (ELISA).ResultsThere was no difference between HIV-infected and HIV-uninfected study participants in terms of CD4+ T-cell responses after anti-CD3 stimulation (P = .19) although HIV-infected participants had significantly higher CD8+ T-cell responses (P = .03). In contrast, there was a significant loss in VV-specific CD4+ T-cell memory among HIV-infected participants (P = .04) whereas antiviral CD8+ T-cell memory remained intact (P > .99). VV-specific antibodies were maintained indefinitely among HIV-uninfected participants (half-life, infinity; 95% confidence interval, 309 years to infinity) but declined rapidly among HIV-infected participants (half-life; 39 years; 24-108 years; P = .001).ConclusionsDespite antiretroviral therapy-associated improvement in CD4+ T-cell counts (nadir, 350/μL after antiretroviral therapy), antigen-specific CD4+ T-cell memory to vaccinations or infections that occurred before HIV infection did not recover after immune reconstitution, and a previously unrealized decline in preexisting antibody responses was observed.