科研之友
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摘要
Objective: Sustained antiretroviral therapy (ART)-mediated viral suppression restores responses to vaccination in HIV-1-infected individuals. As ART interruption occur frequently in resource-constrained settings, we studied their effects on the ability to mount humoral immune responses against a neoantigen. %26lt;br%26gt;Design: Treatment-naive HIV-1-infected individuals were treated with stavudine, lamuvidine and lopinavir/ritonovir. Individuals who maintained viral load less than 50 copies/ml and CD4(+) T-cell counts more than 450 cells/mu l for 6 months received three doses of rabies vaccine, and were randomized to 72 weeks of continuous ART (arm 1) or sequential 2, 4 and 8-week ART interruptions (arm 2). An additional vaccine dose was administered at study end. %26lt;br%26gt;Methods: Neutralizing antibody titers to rabies virus were assessed in plasma with a rapid fluorescent focus-inhibiting test. %26lt;br%26gt;Results: The proportion of participants achieving protective (%26gt;0.5 IU/ml) antibody titer after vaccination was similar (arm 1 = 92%; arm 2 = 91%), but over time the cumulative proportion of observations with protective titer was greater in arm 1 than arm 2 (P = 0.0177). From week 26 after vaccination, antibody titers were lower in arm 2 than arm 1, and volunteers in arm 2 lost protective antibody titers at a greater rate (P = 0.0029). After boosting, 100% of arm 1 and 95% arm 2 volunteers achieved protective antibody titer. %26lt;br%26gt;Conclusion: Our data indicate that individuals undergoing recurring ART interruption retain lower neutralizing antibody titers to a neoantigen, but maintain the ability to mount secondary responses upon boosting, suggesting that they might benefit from vaccine schedule intensification.
- 出版日期2012-7-17
