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 journalArticle

28 Citations (Scopus)

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)
JournalAIDS
Volume14
Issue number4
DOIs
StatePublished - 2000

Fingerprint

Secondary Immunization
Bacteriophages
HIV-1
Zidovudine
Viremia
Immunization
Antibody Formation
Immunoglobulin M
Antibodies
Immunoglobulin G
Tetanus Toxoid
CD4 Lymphocyte Count
Viral Load
Vaccination
Therapeutics
Vaccines
Lymphocytes
T-Lymphocytes
Phenotype

Keywords

  • Bacteriophage immunization
  • HIV infection
  • Immune attribution

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Progressive specific immune attrition after primary, secondary and tertiary immunizations with bacteriophage φX174 in asymptomatic HIV-1 infected patients. / Rubinstein, Arye; Mizrachi, Yaffa; Bernstein, Larry; Shliozberg, Jenny; Golodner, Mala; Liu, Geng Qi; Ochs, Hans D.

In: AIDS, Vol. 14, No. 4, 2000.

Research output: Contribution to journalArticle

Rubinstein, Arye ; Mizrachi, Yaffa ; Bernstein, Larry ; Shliozberg, Jenny ; Golodner, Mala ; Liu, Geng Qi ; Ochs, Hans D. / Progressive specific immune attrition after primary, secondary and tertiary immunizations with bacteriophage φX174 in asymptomatic HIV-1 infected patients. In: AIDS. 2000 ; Vol. 14, No. 4.
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T1 - Progressive specific immune attrition after primary, secondary and tertiary immunizations with bacteriophage φX174 in asymptomatic HIV-1 infected patients

AU - Rubinstein, Arye

AU - Mizrachi, Yaffa

AU - Bernstein, Larry

AU - Shliozberg, Jenny

AU - Golodner, Mala

AU - Liu, Geng Qi

AU - Ochs, Hans D.

PY - 2000

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N2 - 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.

AB - 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.

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KW - HIV infection

KW - Immune attribution

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