Restoration of the antibody response upon rabies vaccination in HIV-infected patients treated with HAART

• Published in: AIDS (London) Vol. 23; no. 18; pp. 2451 - 2458
• Main Authors: GELINCK, Luc B. S, JOI-VAN DER ZIJDE, Cornelia M, JANSEN-HOOGENDIJK, Anja M, BRINKMAN, Daniëlle M. C, VAN DISSEL, Jaap T, VAN TOL, Maarten J. D, KROON, Frank P
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 27.11.2009
• Subjects: Adult; Age; Aged; AIDS/HIV; Anti-Retroviral Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antibodies, Viral - immunology; Antibody Formation - physiology; Antibody response; Antiretroviral Therapy, Highly Active; Antiviral agents; Avidity; Biological and medical sciences; CD4 antigen; CD4-Positive T-Lymphocytes; Class switching; Female; Flow cytometry; highly active antiretroviral therapy; HIV Infections - drug therapy; HIV Infections - immunology; HIV-1 - immunology; Human immunodeficiency virus; Human viral diseases; Humans; Immune response; Immunoglobulin A; Immunoglobulin A - blood; Immunoglobulin G; Immunoglobulin G - blood; Immunoglobulin M; Immunoglobulin M - blood; Infectious diseases; Lymphocytes T; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Rabies; Rabies Vaccines - administration & dosage; Rabies Vaccines - immunology; Vaccination; Vaccines; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral diseases of the nervous system; Viral Load; Young Adult; Immunopathology; Nervous system diseases; Antibody; Vaccination; Retroviridae; Immune reconstitution; AIDS; Immune deficiency; Lentivirus; Infection; Prevention; Virus; Immunoprophylaxis; Chemotherapy; Treatment; HIV; Viral disease; Rabies; Antiviral; Human immunodeficiency virus; functional immune restoration; rabies vaccination; Neoantigen; HAART
• ISSN: 0269-9370; 1473-5571
• DOI: 10.1097/QAD.0b013e328331a43b

Rabies vaccine was used as a T-cell-dependent neoantigen to investigate several aspects of the primary and booster immune response in vivo in HIV-infected individuals receiving antiretroviral treatment. Study participants received rabies vaccination twice, within a 3-month interval. Serum samples were taken before and 1, 2 and 4 weeks after both vaccinations and 1 and 5 years after the primary vaccination. Antirabies antibodies [immunoglobulin G (IgG), IgG subclasses, immunoglobulin A (IgA) and immunoglobulin M (IgM)] were determined; antibody avidity was measured after both vaccinations. T-cell subsets were characterized by flow cytometry. Eighteen healthy controls and 30 HIV-infected adults, treated with HAART for almost 4 years, with a median CD4(+) T-cell count of 537 cells/microl, were immunized. The postvaccination concentrations of antirabies IgG and IgM were significantly lower in HIV-infected individuals as compared with controls. Three T-cell-dependent processes, a true booster response, a class switch from IgM to IgG and avidity maturation were present in both healthy controls and HIV-infected individuals. Higher age was associated with lower postvaccination antirabies IgG and IgM titers. Five years after the primary vaccination, 63% of the HIV-infected individuals still had antibody titers above the protection threshold. Immune restoration in HIV-infected individuals treated with HAART, resulting in a CD4(+) T-cell count greater than 500 cells/microl, is incomplete. However, the majority of HIV-infected individuals are capable of mounting a long-lasting immune response, including several pivotal T-cell-dependent processes, upon vaccination with a neoantigen such as the rabies vaccine.