Progressive specific immune attrition after primary, secondary and tertiary immunizations with bacteriophage φX174 in asymptomatic HIV-1 infected patients

Arye Rubinstein, Yaffa Mizrachi, Larry Bernstein, Jenny Shliozberg, Mala Golodner, Geng Qi Liu, Hans D. Ochs

Research output: Contribution to journalArticlepeer-review

32 Scopus citations

Abstract

Background: Antibody responses to immunization are often compromised in patients infected by HIV-1, and the use of childhood immunization in affected children is controversial. We investigated whether multiple immunizations with a T cell-dependent neoantigen, bacteriophage φX174, induce selective immune attrition and post-vaccination viremia. Methods: Seventeen asymptomatic, antiretroviral therapy-naive HIV-1-infected patients with a CD4 cell count of 450 cells/μl or greater were immunized in 1990/1991 with three intravenous doses of bacteriophage φX174. Group 1 received zidovudine (ZDV) during the primary and secondary immunization. Group 2 received ZDV exclusively during the tertiary immunization. Bacteriophage-specific antibodies of the IgM and IgG class, lymphocyte phenotypes (CD4+, CD8+, CD4+DR+, CD8+DR+, CD4+CD45RO+ and CD4+45RA+, CD4+CD45RO+DR+) and HIV-1 plasma viremia were measured sequentially. Results: In both patient groups the primary, secondary and tertiary antibody responses, as expressed by geometric mean antibody titres and IgM to IgG switch, were impaired. Booster immunizations resulted in a progressive attrition of specific antibody responses to bacteriophage. Antibodies to tetanus toxoid remained stable. The HIV-1 viral loads, which were evaluated in archived specimens from eight patients, increased after immunization but returned to baseline appoximately 4 weeks later. The humoral immune attrition and increases in plasma viremia were blunted by concomitant short courses of ZDV. Discussion: Multiple boosters of immunizations in asymptomatic treatment-naive HIV-1-infected patients may result in a specific immune attrition and vaccine-induced viremia. Short-term monotherapy with ZDV may have blunted these adverse effects. Hyperimmunization of HIV-1-infected patients may be detrimental unless accompanied by antiretroviral therapy. (C) 2000 Lippincott Williams and Wilkins.

Original languageEnglish (US)
Pages (from-to)F55-F62
JournalAIDS
Volume14
Issue number4
DOIs
StatePublished - 2000

Keywords

  • Bacteriophage immunization
  • HIV infection
  • Immune attribution

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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