Estudio de la influencia de estímulos inmunológicos repetidos en forma de un calendario vacunal en pacientes adultos infectados por el virus de la inmunodeficiencia humana en estadios tempranos de la infección (con tratamiento antirretroviral y tras su suspensión).
SUMMARY: "Study of the influence of immunological repeated stimuli with commercial vaccines over the Viral Load (VL), resistance development and specific immunological response against HIV in early stage HIV patients with undetectable VL after HAART" INTRODUCTION: As HIV-infected patients are considered immunocompromised, it is generally recommended that they have to receipt appropriate vaccines. However data are conflicting concerning potential harmful effects following the administration of commercial vaccines in HIV-infected patients. Transient increases (blips) in the viral load have been described associated with a single dose of vaccine, with the potential risk of developing resistance to HAART. On the other hand, there has been described that patients with blips can have an increase in HIV-specific immune responses, which may help to improve the viral control. PATIENTS AND METHODS: We have performed a clinical trial to evaluate the effect of a vaccination program in successfully treated HIV-infected adults on HAART compared to placebo. Its influence over viral load (including resistances), lymphocyte subsets, specific anti-HIV responses, thymic function and responses to vaccinations were analysed. There were also studied the influence of blips over immunity and the influence of interrupting HAART over thymic function and vaccination responses. RESULTS: Vaccinations were not associated to more detectable viral loads, but induced an increase in lymphocyte activation and a loss of CD4+ T-cells. They were not useful as immunotherapy because viral load rebounded after HAART interruption in the same way in placebo and vaccinated group, although specific CD8+ responses against HIV were higher in the latest. Patients with blips had less CD4+ T-cells, more specific CD8+ responses against HIV, and a higher rebound of viral load after discontinuing HAART. After HAART interruption, thymic function decreased firstly, but later presented a partial recovery. Humoral responses to vaccines decreased after stopping HAART. CONCLUSIONS: Vaccinations in HIV patients were safe and did not associate with more detectable viral loads. However, they induce a loss in CD4 T cells. They were not useful as immunotherapy.
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Advisor:Gatell Artigas, Josep Maria; García Alcaide, Felipe; Plana Prades, Montserat
School:Universitat de Barcelona
Source Type:Master's Thesis
Date of Publication:01/09/2007