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Loubet P, Lelievre JD, François A, Botelho-Nevers E, Chidiac C, Chirio D, Dubee V, Dussol B, Galtier F, Hessamfar M, Hodaj E, Jaffuel S, Lacombe K, Laine F, Lefebvre M, Maakaroun-Vermesse Z, Makinson A, Portefaix A, Pourcher V, Rey D, Zucman D, Longobardi J, Bertheau M, Tartour E, de Lamballerie X, Launay O, Wittkop L. Humoral response after mRNA COVID-19 primary vaccination and single booster dose in people living with HIV compared to controls: a French nationwide multicenter cohort study - ANRS0001s COV-POPART. Int J Infect Dis 2024:107110. [PMID: 38825164 DOI: 10.1016/j.ijid.2024.107110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/21/2024] [Accepted: 05/21/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND This study aimed to compare the humoral responses to mRNA COVID-19 vaccination in PWH and HIV-negative individuals. METHODS We included PWH with an undetectable viral load under ART and HIV-negative participants from the French nationwide ANRS COV-POPART cohort who had received two doses of vaccine as a primary vaccination. We compared humoral response between controls and PWH, stratified by CD4 cell count (< 200/mm3 and ≥ 200/mm3 CD4 cell counts) at 1, 6 and 12 months after primary vaccination. RESULTS A total of 1776 participants were included in this analysis, 684 PWH (99% were on ART, median CD4 counts 673 cells/mm3) and 1092 controls. At 1 month, after adjustment on age, sex and BMI, PWH had lower seroneutralization titers than controls and PWH with < 200 CD4 cell/mm3 had lower anti- Spike SARS-CoV-2 IgG antibodies. Same results were found at 6 months. However, in participants who received a booster dose between 6 and 12 months post primary vaccination, we did not observe differences between PWH and controls at 12 months. CONCLUSION PWH had high responses to primary mRNA COVID-19 vaccination. In those who received a booster dose after six months, the humoral response at 12 months increased to similar levels to controls, even in those with low CD4 counts at baseline.
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Affiliation(s)
- Paul Loubet
- INSERM, F-CRIN, Reseau Innovative Clinical Research in Vaccinology (IREIVAC) Paris France; Service des Maladies infectieuses et Tropicales, CHU de Nîmes Nîmes France; INSERM U1047 - Université de Montpellier, Nîmes France.
| | | | - Alexis François
- Univ. Bordeaux, INSERM, MART, UMS 54, F-33000 Bordeaux, France
| | - Elisabeth Botelho-Nevers
- Service d'infectiologie, CHU de Saint-Etienne, CIC EC 1408, Epidémiologie clinique, Saint-Étienne, France
| | - Christian Chidiac
- Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France; Centre International de Recherche en Infectiologie, CIRI, INSERM U1111, équipe PHE3ID, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - David Chirio
- Département de Médecine Infectiologique, Hôpital de L'archet, Centre Hospitalier Universitaire, Université Côte d'Azur, Nice, France
| | - Vincent Dubee
- Service des maladies infectieuses et tropicales, CHU d'Angers, Angers, France
| | - Bertrand Dussol
- Centre d'Investigation Clinique 1415, AP-HM, Marseille, France
| | - Florence Galtier
- INSERM CIC 1411, Centre Hospitalier Universitaire de Montpellier, Hôpital Saint-Eloi, Montpellier, France
| | - Mojgan Hessamfar
- Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint André, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France; Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux, France
| | - Enkelejda Hodaj
- Inserm Centre d'Investigation Clinique 1406, Centre Hospitalier Grenoble-Alpes, Grenoble, France
| | - Sylvain Jaffuel
- Service des Maladies Infectieuses et Tropicales; CIC Inserm 1412, CHU de Brest, Hôpital de la Cavale Blanche, Brest, France
| | - Karine Lacombe
- Sorbonne Université, Inserm IPLESP, Service de maladies infectieuses et tropicales Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Fabrice Laine
- Université de Rennes, Centre Hospitalier Universitaire de Rennes, INSERM, CIC 1414, Rennes, France
| | - Maeva Lefebvre
- Service de maladies infectieuses et tropicales, Centre Hospitalier Universitaire Hôtel-Dieu, Inserm CIC-1413, Nantes, France
| | - Zoha Maakaroun-Vermesse
- Centre Hospitalier Régional Universitaire Tours, Institut National de la Santé et de la Recherche Médicale CIC 1415, Tours, France
| | - Alain Makinson
- Département des Maladies Infectieuses et Tropicales, INSERM U1175/IRD UMI 233, Centre Hospitalier Universitaire de Montpellier & Université de Montpellier, Montpellier, France
| | - Aurelie Portefaix
- Hospices civils de Lyon, Centre Investigation Clinique, Inserm 1407, 69500 Bron, France
| | - Valerie Pourcher
- Service de Maladies Infectieuses et tropicales, Hôpital de la Pitié Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université de Paris Sorbonne, Paris France; Sorbonne Université, Inserm, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | - David Rey
- Le Trait d'Union, Centre de Soins de l'Infection par le VIH, NHC, Hôpitaux Universitaires, 67091 Strasbourg, France
| | - David Zucman
- Réseau Ville-Hôpital, Service de Médecine Interne, Hôpital Foch, Suresnes, France
| | | | | | - Eric Tartour
- Service d'Immunologie biologique, Hôpital européen Georges Pompidou/APHP, Paris, France
| | - Xavier de Lamballerie
- Unité des Virus Emergents, Aix-Marseille Université, Institut de Recherche pour le Développement 190, Inserm 1207, Marseille, France
| | - Odile Launay
- INSERM, F-CRIN, Reseau Innovative Clinical Research in Vaccinology (IREIVAC) Paris France; Centre d'Investigation Clinique Cochin Pasteur, INSERM CIC 1417, Hôpital Cochin/APHP, Paris, France; Université de Paris, Paris, France
| | - Linda Wittkop
- Univ. Bordeaux, INSERM, MART, UMS 54, F-33000 Bordeaux, France; INRIA SISTM team, Talence, France; CHU de Bordeaux, Service d'information médicale, INSERM, F-33000 Bordeaux, France
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2
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Samri A, Bandeira AC, Gois LL, Silva CGR, Rousseau A, Corneau A, Tarantino N, Maucourant C, Queiroz GAN, Vieillard V, Yssel H, Campos GS, Sardi S, Autran B, Rios Grassi MF. Comprehensive analysis of early T cell responses to acute Zika Virus infection during the first epidemic in Bahia, Brazil. PLoS One 2024; 19:e0302684. [PMID: 38722858 PMCID: PMC11081376 DOI: 10.1371/journal.pone.0302684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/05/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND In most cases, Zika virus (ZIKV) causes a self-limited acute illness in adults, characterized by mild clinical symptoms that resolve within a few days. Immune responses, both innate and adaptive, play a central role in controlling and eliminating virus-infected cells during the early stages of infection. AIM To test the hypothesis that circulating T cells exhibit phenotypic and functional activation characteristics during the viremic phase of ZIKV infection. METHODS A comprehensive analysis using mass cytometry was performed on peripheral blood mononuclear cells obtained from patients with acute ZIKV infection (as confirmed by RT-PCR) and compared with that from healthy donors (HD). The frequency of IFN-γ-producing T cells in response to peptide pools covering immunogenic regions of structural and nonstructural ZIKV proteins was quantified using an ELISpot assay. RESULTS Circulating CD4+ and CD8+ T lymphocytes from ZIKV-infected patients expressed higher levels of IFN-γ and pSTAT-5, as well as cell surface markers associated with proliferation (Ki-67), activation ((HLA-DR, CD38) or exhaustion (PD1 and CTLA-4), compared to those from HD. Activation of CD4+ and CD8+ memory T cell subsets, including Transitional Memory T Cells (TTM), Effector Memory T cells (TEM), and Effector Memory T cells Re-expressing CD45RA (TEMRA), was prominent among CD4+ T cell subset of ZIKV-infected patients and was associated with increased levels of IFN-γ, pSTAT-5, Ki-67, CTLA-4, and PD1, as compared to HD. Additionally, approximately 30% of ZIKV-infected patients exhibited a T cell response primarily directed against the ZIKV NS5 protein. CONCLUSION Circulating T lymphocytes spontaneously produce IFN-γ and express elevated levels of pSTAT-5 during the early phase of ZIKV infection whereas recognition of ZIKV antigen results in the generation of virus-specific IFN-γ-producing T cells.
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Affiliation(s)
- Assia Samri
- Sorbonne-Université, Inserm 1135, CNRS ERL8255, Centre d’immunologie et des Maladies Infectieuses, Cimi, Paris, France
| | - Antonio Carlos Bandeira
- Secretaria de Saúde da Bahia, Salvador, Bahia, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
| | - Luana Leandro Gois
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
- Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil
- Departamento de Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | | | - Alice Rousseau
- Sorbonne-Université, Inserm 1135, CNRS ERL8255, Centre d’immunologie et des Maladies Infectieuses, Cimi, Paris, France
| | - Aurelien Corneau
- Faculté de Médecine Pierre et Marie Curie, Plateforme de Cytométrie (CyPS), UMS30–LUMIC, Paris, France
| | - Nadine Tarantino
- Sorbonne-Université, Inserm 1135, CNRS ERL8255, Centre d’immunologie et des Maladies Infectieuses, Cimi, Paris, France
| | - Christopher Maucourant
- Sorbonne-Université, Inserm 1135, CNRS ERL8255, Centre d’immunologie et des Maladies Infectieuses, Cimi, Paris, France
| | - Gabriel Andrade Nonato Queiroz
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
- Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil
| | - Vincent Vieillard
- Sorbonne-Université, Inserm 1135, CNRS ERL8255, Centre d’immunologie et des Maladies Infectieuses, Cimi, Paris, France
| | - Hans Yssel
- Sorbonne-Université, Inserm 1135, CNRS ERL8255, Centre d’immunologie et des Maladies Infectieuses, Cimi, Paris, France
| | - Gubio Soares Campos
- Departamento de Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - Silvia Sardi
- Departamento de Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - Brigitte Autran
- Sorbonne-Université, Inserm 1135, CNRS ERL8255, Centre d’immunologie et des Maladies Infectieuses, Cimi, Paris, France
| | - Maria Fernanda Rios Grassi
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
- Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil
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3
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Motta E, Camacho LAB, Filippis AMBD, Costa M, Pedro L, Cardoso SW, Souza MCDO, Mendes YDS, Grinsztejn B, Coelho LE. Safety of the yellow fever vaccine in people living with HIV: a longitudinal study exploring post-vaccination viremia and hematological and liver kinetics. Braz J Infect Dis 2024; 28:103719. [PMID: 38341187 PMCID: PMC10904163 DOI: 10.1016/j.bjid.2024.103719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 01/04/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Safety data on the yellow fever vaccine 17DD in People Living with HIV (PLWH) are limited. This study explored the occurrence of post-vaccination 17DD viremia and the kinetics of hematological and liver laboratorial parameters in PLWH and HIV-uninfected participants [HIV(-) controls]. METHODS We conducted a secondary analysis of a longitudinal interventional trial (NCT03132311) study that enrolled PLWH and HIV(-) controls to receive a single 17DD dose and were followed at 5, 30 and 365 days after vaccination in Rio de Janeiro, Brazil. 17DD viremia (obtained throughreal-time PCR and plaque forming units' assays), hematological (neutrophils, lymphocytes and platelets counts) and liver enzymes (ALT and AST) results were assessed at baseline and Days 5 and 30 post-vaccination. Logistic regression models explored factors associated with the odds of having positive 17DD viremia. Linear regression models explored variables associated with hematological and liver enzymes results at Day 5. RESULTS A total of 202 PLWH with CD4 ≥ 200 cells/µL and 68 HIV(-) controls were included in the analyses. 17DD viremia was found in 20.0 % of the participants and was twice more frequent in PLWH than in HIV(-) controls (22.8% vs. 11.8 %, p-value < 0.001). Neutrophils, lymphocytes and platelets counts dropped at Day 5 and returned to baseline values at Day 30. 17DD viremia was associated with lower nadir of lymphocytes and platelets at Day 5. ALT levels did not increase post-vaccination and were not associated with 17DD viremia. CONCLUSIONS 17DD was safe and well-tolerated in PLWH with CD4 ≥ 200 cells/µL. Post-vaccination viremia was more frequent in PLWH than in controls. Transient and self-limited decreases in lymphocytes and neutrophils occurred early after vaccination. 17DD viremia was associated with lower lymphocytes and platelets nadir after vaccination. We did not observe elevations in ALT after 17DD vaccination.
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Affiliation(s)
- Edwiges Motta
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas (INI), Rio de Janeiro, RJ, Brazil
| | - Luiz Antonio B Camacho
- Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sérgio Arouca (ENSP), Rio de Janeiro, RJ, Brazil
| | - Ana M Bispo de Filippis
- Fundação Oswaldo Cruz, Laboratório de Arbovírus e Vírus Hemorrágicos, Instituto Oswaldo Cruz (IOC), Rio de Janeiro, RJ, Brazil
| | - Marcellus Costa
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas (INI), Rio de Janeiro, RJ, Brazil
| | - Luciana Pedro
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas (INI), Rio de Janeiro, RJ, Brazil
| | - Sandra W Cardoso
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas (INI), Rio de Janeiro, RJ, Brazil
| | | | - Ygara da Silva Mendes
- Fundação Oswaldo Cruz, Laboratório de Tecnologia Virológica, Biomanguinhos, Rio de Janeiro, RJ, Brazil
| | - Beatriz Grinsztejn
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas (INI), Rio de Janeiro, RJ, Brazil
| | - Lara E Coelho
- Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas (INI), Rio de Janeiro, RJ, Brazil.
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Macieira KV, Caetano DG, De Lima SMB, Wagner Giacoia-Gripp CB, Côrtes FH, Da Silva Cazote A, De Souza Azevedo Soares A, Dos Santos Alves N, De Souza Borges Quintana M, Costa M, Brandão LGP, De Andrade MM, Grinsztejn B, Coelho LE, De Almeida DV. Differential gene expression of cytokines, receptors, and miRNAs in individuals living with HIV-1 and vaccinated against yellow fever. Mol Immunol 2023; 164:58-65. [PMID: 37952362 DOI: 10.1016/j.molimm.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/10/2023] [Accepted: 10/27/2023] [Indexed: 11/14/2023]
Abstract
Between 2016 and 2018, Brazil faced a yellow fever (YF) outbreak, which led to an expansion of vaccination coverage. The coexistence of the YF outbreak and the HIV-1 epidemic in Brazil raised concerns regarding the immune response and vaccine effectiveness in individuals living with HIV (PLWH). The aim of this study was to investigate the immune response to YF vaccination in PLWH and HIV-uninfected individuals as controls. Transcript levels of immunomodulatory molecules, including IL-6, IL-10, IL-21, TGF-β, CD19, CD163, miR-21, miR-146, and miR-155, were measured using RTqPCR. TCD4+ cells were evaluated by cytometry, and neutralizing antibody (Nab) titers were detected by a micro plaque-reduction neutralization test. The findings of our study revealed several noteworthy observations. First, there was a notable reduction in the circulation of TCD4+ cells postvaccination. Among people living with HIV (PLWH), we observed an increase in the expression of IL-10 following vaccination, while IL-6 expression was diminished in PLWH with lower TCD4+ counts. Furthermore, we identified the downregulation of CD19 and TGF-β, along with the upregulation of IL-21 and CD163. Notably, we observed positive correlations between the levels of IL-10/IL-21, IL-10/CD163, and IL-6/CD19. Additionally, there was a positive correlation between miRNAs 146 and 155. It is important to emphasize that all participants exhibited robust neutralizing antibody responses after receiving 17DD YF vaccination. In this context, the gene expression data presented can be useful for biomarker studies of protective antibodies induced by YF vaccination. This study sheds light on immune mechanisms in individuals living with HIV and YF vaccination.
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Affiliation(s)
- Karine Venegas Macieira
- Laboratório de Aids e Imunologia Molecular (LABAIDS), Instituto Oswaldo Cruz, Fiocruz, Rio De Janeiro, Brazil
| | - Diogo Gama Caetano
- Laboratório de Aids e Imunologia Molecular (LABAIDS), Instituto Oswaldo Cruz, Fiocruz, Rio De Janeiro, Brazil
| | - Sheila Maria Barbosa De Lima
- Departamento de Desenvolvimento Experimental e pré-Clínico (DEDEP), Bio-Manguinhos/Fiocruz, Rio de Janeiro, Brazil
| | | | - Fernanda Heloise Côrtes
- Laboratório de Aids e Imunologia Molecular (LABAIDS), Instituto Oswaldo Cruz, Fiocruz, Rio De Janeiro, Brazil
| | - Andressa Da Silva Cazote
- Laboratório de Aids e Imunologia Molecular (LABAIDS), Instituto Oswaldo Cruz, Fiocruz, Rio De Janeiro, Brazil
| | | | | | | | - Marcellus Costa
- Instituto Nacional de Infectologia Evandro Chagas (INI) - Fiocruz, Rio De Janeiro, Brazil
| | | | | | - Beatriz Grinsztejn
- Instituto Nacional de Infectologia Evandro Chagas (INI) - Fiocruz, Rio De Janeiro, Brazil
| | - Lara Esteves Coelho
- Instituto Nacional de Infectologia Evandro Chagas (INI) - Fiocruz, Rio De Janeiro, Brazil
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5
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Motta E, Camacho LAB, Cunha M, de Filippis AMB, Lima SM, Costa M, Pedro L, Cardoso SW, Cortes FH, Giacoia-Gripp CB, Morata M, Nazer S, Moreira RI, de Oliveira Souza MC, Mendes YS, de Souza Azevedo A, dos Santos Alvez N, Grinsztejn B, Coelho LE. Immunogenicity and reactogenicity of yellow fever vaccine in people with HIV. AIDS 2023; 37:2319-2329. [PMID: 37650759 PMCID: PMC10653289 DOI: 10.1097/qad.0000000000003696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/08/2023] [Accepted: 08/08/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE To evaluate immunogenicity and reactogenicity of yellow fever (YF) vaccine in people with HIV (PWH) compared to HIV-uninfected controls. DESIGN In this longitudinal interventional trial (NCT03132311), PWH with CD4 + cell count ≥200 cells/μl and controls, aged 18-59, without a previous history of YF vaccination received a single standard dose of YF vaccine (17DD) and were followed at Days 5, 30 and Year 1. METHODS YF-neutralization titers were measured at Days 0, 30 and Year 1 and geometric mean titers (GMT) were calculated. Adverse events (AE) and YF virus detection were measured at Days 5 and 30. Linear regression evaluated factors associated with YF-neutralization titers. RESULTS Two hundred and eighteen PWH and 82 controls were included. At baseline, all PWH were using antiretroviral therapy; 92.6% had undetectable HIV viral load (VL) and median CD4 + cell count was 630 cells/μl [interquartile range (IQR) 463-888]. YF vaccine was safe and there were no serious AEs. At Day 30, seroconversion was observed in 98.6% of PWH [95% confidence interval (CI): 95.6-99.6] and in 100% of controls (95% CI: 93.9-100); at Year 1, 94.0% of PWH (95% CI: 89.6-96.7) and 98.4% of controls (95% CI 90.3-99.9) were seropositive. PWH had lower GMTs than controls at Day 30 and Year 1. Baseline VL >1000 copies/ml, low CD4 + cell count and low CD4 + /CD8 + ratio were associated with lower YF-neutralization titers. CONCLUSIONS YF vaccine is safe in PWH with CD4 + cell count ≥200 cells/μl. YF vaccine immunogenicity is impaired in PWH, particularly among those with high VL, low CD4 + cell count and low CD4 + /CD8 + ratio at vaccination and YF-neutralization titers decays over time.
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Affiliation(s)
- Edwiges Motta
- Instituto Nacional de Infectologia Evandro Chagas - Fundação Oswaldo Cruz
| | | | - Marcelo Cunha
- Escola Nacional de Saúde Pública Sérgio Arouca - Fundação Oswaldo Cruz
| | | | - Sheila M.B. Lima
- Departamento de Desenvolvimento Experimental e pré-Clínico (DEDEP), Bio-Manguinhos/Fiocruz
| | - Marcellus Costa
- Instituto Nacional de Infectologia Evandro Chagas - Fundação Oswaldo Cruz
| | - Luciana Pedro
- Instituto Nacional de Infectologia Evandro Chagas - Fundação Oswaldo Cruz
| | - Sandra W. Cardoso
- Instituto Nacional de Infectologia Evandro Chagas - Fundação Oswaldo Cruz
| | | | | | - Michelle Morata
- Instituto Nacional de Infectologia Evandro Chagas - Fundação Oswaldo Cruz
| | - Sandro Nazer
- Instituto Nacional de Infectologia Evandro Chagas - Fundação Oswaldo Cruz
| | - Ronaldo Ismério Moreira
- Instituto Nacional de Infectologia Evandro Chagas - Fundação Oswaldo Cruz
- Escola Nacional de Saúde Pública Sérgio Arouca - Fundação Oswaldo Cruz
| | | | - Ygara S. Mendes
- Laboratório de Tecnologia Virológica (LATEV), Bio-Manguinhos/Fiocruz
| | | | | | - Beatriz Grinsztejn
- Instituto Nacional de Infectologia Evandro Chagas - Fundação Oswaldo Cruz
| | - Lara E. Coelho
- Instituto Nacional de Infectologia Evandro Chagas - Fundação Oswaldo Cruz
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Kling K, Domingo C, Bogdan C, Duffy S, Harder T, Howick J, Kleijnen J, McDermott K, Wichmann O, Wilder-Smith A, Wolff R. Duration of Protection After Vaccination Against Yellow Fever: A Systematic Review and Meta-Analysis. Clin Infect Dis 2022; 75:2266-2274. [PMID: 35856638 PMCID: PMC9761887 DOI: 10.1093/cid/ciac580] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/30/2022] [Accepted: 07/13/2022] [Indexed: 01/19/2023] Open
Abstract
The duration of protection after a single dose of yellow fever vaccine is a matter of debate. To summarize the current knowledge, we performed a systematic literature review and meta-analysis. Studies on the duration of protection after 1 and ≥2 vaccine doses were reviewed. Data were stratified by time since vaccination. In our meta-analysis, we used random-effects models. We identified 36 studies from 20 countries, comprising more than 17 000 participants aged 6 months to 85 years. Among healthy adults and children, pooled seroprotection rates after single vaccination dose were close to 100% by 3 months and remained high in adults for 5 to 10 years. In children vaccinated before age 2 years, the seroprotection rate was 52% within 5 years after primary vaccination. For immunodeficient persons, data indicate relevant waning. The extent of waning of seroprotection after yellow fever vaccination depends on age and immune status at primary vaccination.
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Affiliation(s)
- Kerstin Kling
- Immunization Unit, Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Cristina Domingo
- Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Christian Bogdan
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Friedrich Alexander Universität (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Steven Duffy
- Kleijnen Systematic Reviews Ltd, York, United Kingdom
| | - Thomas Harder
- Immunization Unit, Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Jeremy Howick
- Kleijnen Systematic Reviews Ltd, York, United Kingdom
| | - Jos Kleijnen
- Kleijnen Systematic Reviews Ltd, York, United Kingdom
| | | | - Ole Wichmann
- Immunization Unit, Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Annelies Wilder-Smith
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Robert Wolff
- Kleijnen Systematic Reviews Ltd, York, United Kingdom
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7
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Wigg de Araújo Lagos L, de Jesus Lopes de Abreu A, Caetano R, Braga JU. Yellow fever vaccine safety in immunocompromised individuals: a systematic review and meta-analysis. J Travel Med 2022; 30:6659960. [PMID: 35947986 DOI: 10.1093/jtm/taac095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/21/2022] [Accepted: 08/02/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Yellow fever is an arbovirus with variable severity, including severe forms with high mortality. The vaccination is the most effective measure to protect against the disease. Nonserious and serious adverse events have been described in immunocompromised individuals, but previous studies have failed to demonstrate this association. This systematic review assessed the risk of adverse events after yellow fever vaccination in immunocompromised individuals compared to its use in non-immunocompromised individuals. METHODS A search was conducted in the MEDLINE, LILACS, EMBASE, SCOPUS, DARE, Toxiline, Web of Science and grey literature databases for publications until February 2021. Randomized and quasi-randomized clinical trials and observational studies that included immunocompromised participants (individuals with HIV infection, organ transplants, with cancer, who used immunosuppressive drugs for rheumatologic diseases and those on immunosuppressive therapy for other diseases) were selected. The methodological quality of observational or non-randomized studies was assessed by the ROBINS-I tool. Two meta-analyses were performed, proportion and risk factor analyses, to identify the summary measure of relative risk (RR) in the studies that had variables suitable for combination. RESULTS Twenty-five studies were included, most with risk of bias classified as critical. Thirteen studies had enough data to carry out the proposed meta-analyses. Seven studies without a comparator group had their results aggregated in the proportion meta-analysis, identifying an 8.5% (95% CI 0.07-21.8) risk of immunocompromised individuals presenting adverse events after vaccination. Six cohort studies were combined, with an RR of 1.00 (95% CI 0.78-1.29). Subgroup analysis was performed according to the aetiology of immunosuppression and was also unable to identify an increased risk of adverse events following vaccination. CONCLUSIONS It is not possible to affirm that immunocompromised individuals, regardless of aetiology, have a higher risk of adverse events after receiving the yellow fever vaccine.
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Affiliation(s)
- Letícia Wigg de Araújo Lagos
- Núcleo de Avaliação de Tecnologias em Saúde (NATS), Instituto Nacional de Cardiologia, Rio de Janeiro, RJ, Brazil
| | | | - Rosângela Caetano
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - José Ueleres Braga
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
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8
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Spinelli MA, Jones BLH, Gandhi M. COVID-19 Outcomes and Risk Factors Among People Living with HIV. Curr HIV/AIDS Rep 2022; 19:425-432. [PMID: 35930187 PMCID: PMC9362624 DOI: 10.1007/s11904-022-00618-w] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2022] [Indexed: 12/01/2022]
Abstract
Purpose of Review In this review, we examine the intersection of the HIV and COVID-19 epidemics with focus on COVID-19-related health outcomes and risk factors for SARS-CoV-2 among people living with HIV (PLWH). Recent Findings Evidence to date do not suggest a higher incidence of SARS-CoV-2 infection among PLWH compared to the general population, although—once exposed—PLWH are at greater risk of severe COVID-19 outcomes. Key risk factors for severe COVID-19 include non-HIV comorbidities known to be associated with severe disease, as well as HIV-specific risk factors such as low CD4 + T-cell count, unsuppressed viral load, and tuberculosis co-infection. The disproportionate impact of the SARS-CoV-2 pandemic among Black, Latinx, and Native American/Alaskan Native PLWH could worsen pre-existing disparities in health outcomes among PLWH. Data on SARS-CoV-2 vaccine protection among PLWH needs additional study, although some studies suggest decreased humoral responses among those with low CD4 + T-cell counts, while there is a signal of increased vaccine breakthrough rates among PLWH in two large observational cohorts. Data on post-acute sequelae of SARS-CoV-2 (PASC) among PLWH is also limited. Summary PLWH do not have a higher susceptibility to SARS-CoV-2, but once exposed, they are at higher risk of severe COVID-19 outcomes. Additional resources will need to be dedicated to the development of interventions to improve health outcomes and address disparities among PLWH impacted by the COVID-19 pandemic.
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Affiliation(s)
- Matthew A Spinelli
- Division of HIV, ID, and Global Medicine, University of California, San Francisco, CA, 94110, USA
| | - Benjamin L H Jones
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Monica Gandhi
- Division of HIV, ID, and Global Medicine, University of California, San Francisco, CA, 94110, USA.
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9
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Peluso MJ, Donatelli J, Henrich TJ. Long-term immunologic effects of SARS-CoV-2 infection: leveraging translational research methodology to address emerging questions. Transl Res 2022; 241:1-12. [PMID: 34780969 PMCID: PMC8588584 DOI: 10.1016/j.trsl.2021.11.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/02/2021] [Accepted: 11/05/2021] [Indexed: 11/01/2022]
Abstract
The current era of COVID-19 is characterized by emerging variants of concern, waning vaccine- and natural infection-induced immunity, debate over the timing and necessity of vaccine boosting, and the emergence of post-acute sequelae of SARS-CoV-2 infection. As a result, there is an ongoing need for research to promote understanding of the immunology of both natural infection and prevention, especially as SARS-CoV-2 immunology is a rapidly changing field, with new questions arising as the pandemic continues to grow in complexity. The next phase of COVID-19 immunology research will need focus on clearer characterization of the immune processes defining acute illness, development of a better understanding of the immunologic processes driving protracted symptoms and prolonged recovery (ie, post-acute sequelae of SARS-CoV-2 infection), and a growing focus on the impact of therapeutic and prophylactic interventions on the long-term consequences of SARS-CoV-2 infection. In this review, we address what is known about the long-term immune consequences of SARS-CoV-2 infection and propose how experience studying the translational immunology of other infections might inform the approach to some of the key questions that remain.
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Affiliation(s)
- Michael J Peluso
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, California
| | - Joanna Donatelli
- Division Experimental Medicine, University of California, San Francisco, California
| | - Timothy J Henrich
- Division Experimental Medicine, University of California, San Francisco, California.
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10
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Durier C, Mercier-Delarue S, Verdière NCD, Meiffrédy V, Matheron S, Samri A, Resch M, Marchand L, Autran B, Launay O, Simon F. A 5-year neutralizing immune response to yellow fever vaccine in HIV-infected and HIV-uninfected adults. AIDS 2022; 36:319-321. [PMID: 34934023 DOI: 10.1097/qad.0000000000003114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | | | | | | | - Sophie Matheron
- AP-HP Nord Hôpital Bichat - Claude-Bernard, Faculté de Médecine, Université de Paris, INSERM UMR 1137 IAME
| | - Assia Samri
- Sorbonne Université, INSERM 1135, CNRS ERL 8255, Centre d'immunologie et des maladies infectieuses, Cimi-Paris
| | | | | | - Brigitte Autran
- Sorbonne Université, INSERM 1135, CNRS ERL 8255, Centre d'immunologie et des maladies infectieuses, Cimi-Paris
| | - Odile Launay
- AP-HP, Hôpital Cochin Broca Hôtel-Dieu, INSERM, CIC 1417, F-CRIN, I-REIVAC, Université de Paris, Paris, France
| | - François Simon
- AP-HP, Hôpital Saint-Louis, Faculté de Médecine, Université de Paris
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11
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Tonacio AC, do Nascimento Pedrosa T, Borba EF, Aikawa NE, Pasoto SG, Filho JCRF, Sampaio Barros MM, Leon EP, Lombardi SCFS, Junior AM, Azevedo ADS, Schwarcz WD, Fuller R, Yuki EFN, Ugolini Lopes MR, Rodrigues Pereira RM, Sampaio Barros PD, de Andrade DCO, de Medeiros-Ribeiro AC, de Moraes JCB, Shinjo SK, Miossi R, da Silva Duarte AJ, Lopes MH, Kallás EG, Almeida da Silva CA, Bonfá E. Immunogenicity and safety of primary fractional-dose yellow fever vaccine in autoimmune rheumatic diseases. PLoS Negl Trop Dis 2021; 15:e0010002. [PMID: 34843469 PMCID: PMC8659329 DOI: 10.1371/journal.pntd.0010002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 12/09/2021] [Accepted: 11/16/2021] [Indexed: 12/05/2022] Open
Abstract
Background Brazil faced a yellow fever(YF) outbreak in 2016–2018 and vaccination was considered for autoimmune rheumatic disease patients(ARD) with low immunosuppression due to YF high mortality. Objective This study aimed to evaluate, prospectively for the first time, the short-term immunogenicity of the fractional YF vaccine(YFV) immunization in ARD patients with low immunossupression. Methods and Results A total of 318 participants(159 ARD and 159 age- and sex-matched healthy controls) were vaccinated with the fractional-dose(one fifth) of 17DD-YFV. All subjects were evaluated at entry(D0), D5, D10, and D30 post-vaccination for clinical/laboratory and disease activity parameters for ARD patients. Post-vaccination seroconversion rate(83.7%vs.96.6%, p = 0.0006) and geometric mean titers(GMT) of neutralizing antibodies[1143.7 (95%CI 1012.3–1292.2) vs.731 (95%CI 593.6–900.2), p<0.001] were significantly lower in ARD compared to controls. A lower positivity rate of viremia was also identified for ARD patients compared to controls at D5 (53%vs.70%, p = 0.005) and the levels persisted in D10 for patients and reduced for controls(51%vs.19%, p = 0.0001). The viremia was the only variable associated with seroconvertion. No serious adverse events were reported. ARD disease activity parameters remained stable at D30(p>0.05). Conclusion Fractional-dose 17DD-YF vaccine in ARD patients resulted in a high rate of seroconversion rate(>80%) but lower than controls, with a longer but less intense viremia. This vaccine was immunogenic, safe and did not induce flares in ARD under low immunosuppression and may be indicated in YF outbreak situations and for patients who live or travel to endemic areas. Trial registration This clinical trial was registered with Clinicaltrials.gov (#NCT03430388). Yellow fever is a viral hemorragic fever with high mortality rate and the vaccine is a remarkably successful way of preventing it. As a live attenuated virus vaccine, it is not recommended for rheumatic and other immunossupressed patients in general. However, in an outbreak scenario, the risk of dying of the disease can be higher than the risk of a vaccine serious adverse event. In 2018, the fractional-dose yellow fever vaccine was offered to the hospital employees and to the rheumatic patients without or with low immunossupression therapy in Hospital das Clinicas of University of São Paulo, during the yellow fever outbreak in São Paulo, Brazil. In order to optimize the yellow fever vaccine (YFV) supply, the fractional-dose (corresponding to one fifth) was adopted in the public vaccine campaign. This is the first study evaluating the primary vaccination with fractional-dose YFV in autoimmune rheumatic diseases(ARD) patients (n = 159) under low immunosuppression. Most vaccinated participants were able to produce enough neutralizing antibodies to be protected against yellow fever (seroconversion rate of 84% versus 96% in healthy controls). Neither activity of the rheumatic disease or serious adverse event was identified during the 30 days of followup after the vaccination.
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Affiliation(s)
- Adriana Coracini Tonacio
- Department of Infectious and Parasitic Diseases, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
- * E-mail:
| | - Tatiana do Nascimento Pedrosa
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Eduardo Ferreira Borba
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Nadia Emi Aikawa
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Sandra Gofinet Pasoto
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | | | - Elaine Pires Leon
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Alfredo Mendrone Junior
- Laboratório de Segurança Transfusional, Divisão de Pesquisa e Ensino, Fundação Pró-Sangue/Hemocentro de São Paulo, São Paulo, Brazil
| | - Adriana de Souza Azevedo
- Institute of Technology in Immunobiologicals, Bio-Manguinhos, Fundação Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro, Brazil
| | - Waleska Dias Schwarcz
- Institute of Technology in Immunobiologicals, Bio-Manguinhos, Fundação Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro, Brazil
| | - Ricardo Fuller
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Emily Figueiredo Neves Yuki
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Michelle Remião Ugolini Lopes
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Rosa Maria Rodrigues Pereira
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | | | | | | | - Samuel Katsuyuki Shinjo
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Renata Miossi
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Alberto José da Silva Duarte
- Clinical Laboratory Division—Department of Pathology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Marta Heloisa Lopes
- Department of Infectious and Parasitic Diseases, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Esper Georges Kallás
- Department of Infectious and Parasitic Diseases, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Clovis Artur Almeida da Silva
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Eloisa Bonfá
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
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12
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Saint-Lary L, Diallo A, de Monteynard LA, Paul C, Marchand L, Tubiana R, Warszawski J, Mandelbrot L, Rekacewicz C, Petrov-Sanchez V, Faye A, Sibiude J, Dabis F, Sommet A, Leroy V. In utero exposure to antiretroviral drugs and pregnancy outcomes: Analysis of the French ANRS pharmacovigilance database. Br J Clin Pharmacol 2021; 88:942-964. [PMID: 34505718 DOI: 10.1111/bcp.15075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/13/2021] [Accepted: 08/25/2021] [Indexed: 01/08/2023] Open
Abstract
AIMS In 2018, 1.07 million pregnant women received antiretroviral drugs, raising whether this affects pregnancy outcomes. We assessed the adverse pregnancy outcomes associated with prenatal antiretroviral drug exposure, notified to the French ANRS pharmacovigilance system. METHODS An exhaustive case report series has been performed using the ANRS pharmacovigilance database. All ANRS-sponsored HIV clinical research studies using antiretroviral drugs either in pregnant women or women of childbearing age were eligible from 2004 to 2019. We analysed the following pregnancy outcomes: abortion, ectopic pregnancy, stillbirth, prematurity (<37 weeks of gestational age), low birth weight (<2500 g) and congenital abnormalities. A logistic regression was performed to assess the odds ratio (OR) for each outcome separately (if occurrence >50) compared to the outcome observed when exposed to non-nucleoside-reverse-transcriptase-inhibitor (NNRTI)-based regimen as the reference. RESULTS Among the 34 studies selected, 918 deliveries occurred, of whom 88% had pregnancy outcomes documented. Pregnant women were mainly exposed to PI (n = 387, 48.6%), NNRTI (n = 331, 41.5%) and INI-based combinations (n = 40, 5.0%, 18 on dolutegravir). Compared to NNRTI-based combinations, there was no significant association observed with exposure to other antiretroviral combination for spontaneous abortion, prematurity or low birth weight, except an increased risk of low birth weight in new-born exposed to exclusive nucleoside-reverse-transcriptase-inhibitor (NRTI) combinations (n = 4; OR 7.50 [1.49-37.83]). CONCLUSIONS Our study, mainly based on protease inhibitor (PI) and NNRTI-based regimens, is overall reassuring on the risk of adverse pregnancy outcomes, except for NRTI which should be interpreted cautiously (small number, indication bias). In this study, the number of integrase inhibitor (INI)-based combinations was too low to draw any conclusions.
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Affiliation(s)
- Laura Saint-Lary
- CERPOP, Inserm, Université de Toulouse, Université Paul Sabatier III, Toulouse, France
| | - Alpha Diallo
- Clinical Trial Safety and Public Health, ANRS, Paris, Île-de-France, France
| | | | - Christelle Paul
- Clinical Trial Safety and Public Health, ANRS, Paris, Île-de-France, France
| | - Lucie Marchand
- Clinical and Therapeutic Research on HIV and Hepatitis Unit, ANRS, Paris, Île-de-France, France
| | - Roland Tubiana
- University Hospital Pitié Salpêtrière Infectious and Tropical Diseases Service, Sorbonne Université, Inserm UMR-1136 Pierre Louis Institute of Epidemiology and Public Health, Paris, Île-de-France, France
| | - Josiane Warszawski
- Hospital Louis-Mourier, Obstetrics-Gynecology Department, Colombes CESP, Inserm U1018 Université Paris Diderot Risks in Pregnancy University Department, Colombes, Île-de-France, France
| | - Laurent Mandelbrot
- Hospital Louis-Mourier, Service de Gynécologie-Obstétrique, Institut national de la santé et de la recherche médicale Iame-U1137, Université Paris-Diderot, Colombes, Île-de-France, France
| | - Claire Rekacewicz
- International Research and Collaboration Unit, ANRS, Paris, Île-de-France, France
| | | | - Albert Faye
- Robert-Debré Mother-Child University Hospital Division of Paediatric Medicine, Université Paris 7 Denis Diderot, Sorbonne Paris Cité, Inserm U1123, Paris, Île-de-France, France
| | - Jeanne Sibiude
- Maternité Port-Royal, Département Hospitalier Universitaire Risques et Grossesse, Inserm U1018, Paris, Île-de-France, France
| | - François Dabis
- Clinical Trial Safety and Public Health, ANRS, Paris, Île-de-France, France.,Inserm U1219, University of Bordeaux, ISPED, Bordeaux Population Health Research Center, Bordeaux, France
| | - Agnès Sommet
- CERPOP, Inserm, Université de Toulouse, Université Paul Sabatier III, Toulouse, France.,Service de pharmacologie clinique, CHU de Toulouse, Faculté de Médecine, Université Toulouse 3, Toulouse, Midi-Pyrénées, France
| | - Valériane Leroy
- CERPOP, Inserm, Université de Toulouse, Université Paul Sabatier III, Toulouse, France
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13
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Montalvo Zurbia-Flores G, Rollier CS, Reyes-Sandoval A. Re-thinking yellow fever vaccines: fighting old foes with new generation vaccines. Hum Vaccin Immunother 2021; 18:1895644. [PMID: 33974507 PMCID: PMC8920179 DOI: 10.1080/21645515.2021.1895644] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Despite the existence of a highly efficient yellow fever vaccine, yellow fever reemergence throughout Africa and the Americas has put 900 million people in 47 countries at risk of contracting the disease. Although the vaccine has been key to controlling yellow fever epidemics, its live-attenuated nature comes with a range of contraindications that prompts advising against its administration to pregnant and lactating women, immunocompromised individuals, and those with hypersensitivity to chicken egg proteins. Additionally, large outbreaks have highlighted problems with insufficient vaccine supply, whereby manufacturers rely on slow traditional manufacturing processes that prevent them from ramping up production. These limitations have contributed to an inadequate control of yellow fever and have favored the pursuit of novel yellow fever vaccine candidates that aim to circumvent the licensed vaccine’s restrictions. Here, we review the live-attenuated vaccine’s limitations and explore the epitome of a yellow fever vaccine, whilst scrutinizing next-generation vaccine candidates.
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Affiliation(s)
- Gerardo Montalvo Zurbia-Flores
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford. The Henry Wellcome Building for Molecular Physiology, Oxford, UK
| | - Christine S Rollier
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Arturo Reyes-Sandoval
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford. The Henry Wellcome Building for Molecular Physiology, Oxford, UK.,Instituto Politécnico Nacional, IPN. Av. Luis Enrique Erro S/n. Unidad Adolfo López Mateos. CP, Mexico City, Mexico
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14
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Rees-Spear C, McCoy LE. Vaccine responses in ageing and chronic viral infection. OXFORD OPEN IMMUNOLOGY 2021; 2:iqab007. [PMID: 36845567 PMCID: PMC9914503 DOI: 10.1093/oxfimm/iqab007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 02/06/2023] Open
Abstract
Over the last few decades, changing population demographics have shown that there are a growing number of individuals living past the age of 60. With this expanding older population comes an increase in individuals that are more susceptible to chronic illness and disease. An important part of maintaining health in this population is through prophylactic vaccination, however, there is growing evidence that vaccines may be less effective in the elderly. Furthermore, with the success of anti-viral therapies, chronic infections such as HIV are becoming increasingly prevalent in older populations and present a relatively unstudied population with respect to the efficacy of vaccination. Here we will examine the evidence for age-associated reduction in antibody and cellular responsiveness to a variety of common vaccines and investigate the underlying causes attributed to this phenomenon, such as inflammation and senescence. We will also discuss the impact of chronic viral infections on immune responses in both young and elderly patients, particularly those living with HIV, and how this affects vaccinations in these populations.
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Affiliation(s)
- Chloe Rees-Spear
- Division of Infection and Immunity, University College London, London, UK
| | - Laura E McCoy
- Division of Infection and Immunity, University College London, London, UK,Correspondence address. Division of Infection and Immunity, University College London, London, UK. E-mail:
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15
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Koehl B, Aupiais C, Schinckel N, Mornand P, Odièvre MH, Niakate A, Brousse V, Ithier G, Missud F, Holvoet L, Benkerrou M, Sorge F, Faye A. Tolerance and humoral immune response to the yellow fever vaccine in sickle cell disease children treated with hydroxyurea: a multicentre prospective study. J Travel Med 2021; 28:6129658. [PMID: 33550421 DOI: 10.1093/jtm/taab013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/11/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Sickle cell disease (SCD) children are frequent travellers to countries where yellow fever (YF) is endemic, but there are no data regarding the safety and immunogenicity of the vaccine in such children treated with hydroxyurea (HU). The main objective of this study was to compare the tolerance and immune response to YF vaccination in SCD children treated or not with HU. METHOD SCD children < 18 years attending the international travel clinics of three large paediatric centres and requiring a first YF vaccination were included in a prospective study. Adverse events were collected 2 weeks after vaccination. YF vaccine antibody titres were measured ~6 months after vaccination. RESULTS Among the 52 SCD children vaccinated against YF, 17 (33%) were treated with HU. Only mild adverse events, mainly fever and local reaction, were observed in the HU group with a similar frequency in the non-HU group (57 and 35%, respectively, P = 0.30). YF antibody titres were measured in 15/17 patients in the HU group and 23/35 patients in the non-HU group after a median of 6.0 months (3.5-8.5) following vaccination. The geometric mean of YF antibody titre was similar in both groups. A protective antibody level was observed in 85% of the children in the HU group vs 100% in the non-HU group (P = 0.14), suggesting a lower effectiveness of the vaccine in patients on HU similarly to what has been described in patients on immune suppressive therapy for other vaccines. CONCLUSION YF vaccination seems to be safe and efficient in SCD children treated with HU. Considering the potential risk of severe complications in cases of YF while travelling in Africa for those patients, the benefit-to-risk ratio argues for YF vaccination in all SCD children. Control of a protective antibody titre may also be useful to ascertain an adequate response in those treated with HU.
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Affiliation(s)
- Berengere Koehl
- Department of Haematology, Reference Centre of Sickle Cell Disease, Hôpital Robert Debré, APHP, 48 Bd Sérurier, Paris 75019, France.,Université de Paris, 48 Bld Serurier, 75019, Paris, France.,INSERM UMRS 1134, BIGR, 6 rue Alexandre Cabanel, 75015, Paris, France
| | - Camille Aupiais
- INSERM UMRS 1123, ECEVE, 10 avenue de Verdun 75010, Paris, France.,Department of Paediatrics Emergency, Jean Verdier Hospital, APHP, Bondy, France
| | - Nelly Schinckel
- Department of General Paediatrics and Infectious Diseases, Robert Debré Hospital, APHP, Paris, France
| | - Pierre Mornand
- Department of General Paediatrics, Centre for Sickle Cell Disease, Trousseau Hospital, APHP, Sorbonne Université, Paris, France
| | - Marie-Hélène Odièvre
- INSERM UMRS 1134, BIGR, 6 rue Alexandre Cabanel, 75015, Paris, France.,Department of General Paediatrics, Centre for Sickle Cell Disease, Trousseau Hospital, APHP, Sorbonne Université, Paris, France
| | - Assa Niakate
- Department of General Paediatrics, Centre for Sickle Cell Disease, Trousseau Hospital, APHP, Sorbonne Université, Paris, France
| | - Valentine Brousse
- INSERM UMRS 1134, BIGR, 6 rue Alexandre Cabanel, 75015, Paris, France.,Department of General Paediatrics, Necker-Enfants malades hospital, APHP, 149 rue de Sevres, 75015, Paris, France
| | - Ghislaine Ithier
- Department of Haematology, Reference Centre of Sickle Cell Disease, Hôpital Robert Debré, APHP, 48 Bd Sérurier, Paris 75019, France
| | - Florence Missud
- Department of Haematology, Reference Centre of Sickle Cell Disease, Hôpital Robert Debré, APHP, 48 Bd Sérurier, Paris 75019, France
| | - Laurent Holvoet
- Department of Haematology, Reference Centre of Sickle Cell Disease, Hôpital Robert Debré, APHP, 48 Bd Sérurier, Paris 75019, France
| | - Malika Benkerrou
- Department of Haematology, Reference Centre of Sickle Cell Disease, Hôpital Robert Debré, APHP, 48 Bd Sérurier, Paris 75019, France.,INSERM UMRS 1123, ECEVE, 10 avenue de Verdun 75010, Paris, France
| | - Frederic Sorge
- Department of Haematology, Reference Centre of Sickle Cell Disease, Hôpital Robert Debré, APHP, 48 Bd Sérurier, Paris 75019, France
| | - Albert Faye
- Université de Paris, 48 Bld Serurier, 75019, Paris, France.,INSERM UMRS 1123, ECEVE, 10 avenue de Verdun 75010, Paris, France.,Department of General Paediatrics and Infectious Diseases, Robert Debré Hospital, APHP, Paris, France
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16
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Martin C, Domingo C, Bottieau E, Buonfrate D, De Wit S, Van Laethem Y, Dauby N. Immunogenicity and duration of protection after yellow fever vaccine in people living with human immunodeficiency virus: a systematic review. Clin Microbiol Infect 2021; 27:958-967. [PMID: 33813107 DOI: 10.1016/j.cmi.2021.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/16/2021] [Accepted: 03/21/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND We lack the rationale on which to base the development of a yellow fever (YF) vaccination schedule for people living with human immunodeficiency virus (PLWHIV). OBJECTIVES To report on the current evidence regarding the seroconversion rate and the duration of humoral protection after YF vaccine, as well as the impact of revaccination in PLWHIV. DATA SOURCES MEDLINE, Google Scholar, LILACS and Cochrane CENTRAL were searched. METHODS We selected studies on PLWHIV of all ages (including perinatally HIV-infected patients) and all settings (YF endemic and non-endemic zones). Intervention investigated was vaccination against YF, at least once after the HIV diagnosis. The research questions were the seroconversion rate, duration of humoral immunity after YF vaccine and impact of revaccination in PLWHIV. Selected studies were assessed for quality using the Newcastle-Ottawa scale. RESULTS Ten, six and six studies were selected for the systematic review of each question, respectively. Only one study addressed the first question in perinatally HIV-infected children. The quality of the studies was assessed as Poor (n = 16), Fair (n = 2) or Good (n = 4). A meta-analysis demonstrated that 97.6% (95% CI 91.6%-100%) of the included population seroconverted. Between 1 and 10 years after YF vaccine, reported persistence of neutralizing antibodies was 72% (95% CI 53.6%-91%), and it was 62% (95% CI 45.4%-78.6%) more than 10 years after YF vaccine. No conclusions could be drawn on impact of revaccination because of the small number of patients. CONCLUSIONS The current evidence regarding seroconversion rate, duration of humoral protection after YF vaccine and impact of revaccination in PLWHIV is limited by the low number and quality of studies. Based on the presently available data, it is difficult to rationally develop yellow fever vaccination guidelines for PLWHIV.
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Affiliation(s)
- Charlotte Martin
- Infectious Diseases Department, Centre Hospitalier Universitaire Saint-Pierre-Université Libre de Bruxelles, Brussels, Belgium.
| | - Cristina Domingo
- Robert Koch Institute, Highly Pathogenic Viruses (ZBS 1), Centre for Biological Threats and Special Pathogens, WHO Collaborating Centre for Emerging Infections and Biological Threats, Berlin, Germany
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Dora Buonfrate
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy
| | - Stéphane De Wit
- Infectious Diseases Department, Centre Hospitalier Universitaire Saint-Pierre-Université Libre de Bruxelles, Brussels, Belgium
| | - Yves Van Laethem
- Infectious Diseases Department, Centre Hospitalier Universitaire Saint-Pierre-Université Libre de Bruxelles, Brussels, Belgium
| | - Nicolas Dauby
- Infectious Diseases Department, Centre Hospitalier Universitaire Saint-Pierre-Université Libre de Bruxelles, Brussels, Belgium; Institute for Medical Immunology, Université Libre de Bruxelles, Brussels, Belgium; Environmental Health Research Centre, Public Health School, Université Libre de Bruxelles, Brussels, Belgium
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17
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Vacunas en pacientes con VIH/SIDA. REVISTA MÉDICA CLÍNICA LAS CONDES 2020. [DOI: 10.1016/j.rmclc.2020.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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18
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Deguit CDT, Hough M, Hoh R, Krone M, Pilcher CD, Martin JN, Deeks SG, McCune JM, Hunt PW, Rutishauser RL. Some Aspects of CD8+ T-Cell Exhaustion Are Associated With Altered T-Cell Mitochondrial Features and ROS Content in HIV Infection. J Acquir Immune Defic Syndr 2019; 82:211-219. [PMID: 31513075 PMCID: PMC6746248 DOI: 10.1097/qai.0000000000002121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Reversing or preventing T-cell exhaustion is an important treatment goal in the context of HIV disease; however, the mechanisms that regulate HIV-specific CD8 T-cell exhaustion are incompletely understood. Since mitochondrial mass (MM), mitochondrial membrane potential (MMP), and cellular reactive oxygen species (ROS) content are altered in exhausted CD8 T cells in other settings, we hypothesized that similar lesions may arise in HIV infection. METHODS We sampled cryopreserved peripheral blood mononuclear cells from HIV-uninfected (n = 10) and HIV-infected participants with varying levels and mechanisms of viral control: viremic (VL > 2000 copies/mL; n = 8) or aviremic (VL < 40 copies/mL) due to antiretroviral therapy (n = 11) or natural control (n = 9). We characterized the MM, MMP, and ROS content of bulk CD8 T cells and MHC class I tetramer+ HIV-specific CD8 T cells by flow cytometry. RESULTS We observed higher MM, MMP, and ROS content across bulk effector-memory CD8 T-cell subsets in HIV-infected compared with HIV-uninfected participants. Among HIV-specific CD8 T cells, these features did not vary by the extent or mechanism of viral control but were significantly altered in cells displaying characteristics associated with exhaustion (eg, high PD-1 expression, low CD127 expression, and impaired proliferative capacity). CONCLUSIONS While we did not find that control of HIV replication in vivo correlates with the CD8 T-cell MM, MMP, or ROS content, we did find that some features of CD8 T-cell exhaustion are associated with alterations in mitochondrial state. Our findings support further studies to probe the relationship between mitochondrial dynamics and CD8 T-cell functionality in HIV infection.
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Affiliation(s)
- Christian Deo T. Deguit
- Department of Medicine, University of California, San Francisco, San Francisco, CA, U.S.A
- Current Address: Department of Biochemistry and Molecular Biology, University of the Philippines, Manila, Philippines
| | - Michelle Hough
- Department of Medicine, University of California, San Francisco, San Francisco, CA, U.S.A
- Current Address: Department of Medicine, University of Southern California, Los Angeles, CA, U.S.A
| | - Rebecca Hoh
- Department of Medicine, University of California, San Francisco, San Francisco, CA, U.S.A
| | - Melissa Krone
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, U.S.A
| | - Christopher D. Pilcher
- Department of Medicine, University of California, San Francisco, San Francisco, CA, U.S.A
| | - Jeffrey N. Martin
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, U.S.A
| | - Steven G. Deeks
- Department of Medicine, University of California, San Francisco, San Francisco, CA, U.S.A
| | - Joseph M. McCune
- Department of Medicine, University of California, San Francisco, San Francisco, CA, U.S.A
- Current Address: Bill & Melinda Gates Foundation, Seattle, WA, U.S.A
| | - Peter W. Hunt
- Department of Medicine, University of California, San Francisco, San Francisco, CA, U.S.A
| | - Rachel L. Rutishauser
- Department of Medicine, University of California, San Francisco, San Francisco, CA, U.S.A
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19
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Vieillard V, Combadière B, Tubiana R, Launay O, Pialoux G, Cotte L, Girard PM, Simon A, Dudoit Y, Reynes J, Rockstroh J, Garcia F, Gatell J, Devidas A, Yazdanpanah Y, Weiss L, Fätkenheuer G, Autran B, Joyeux D, Gharakhanian S, Debré P, Katlama C. HIV therapeutic vaccine enhances non-exhausted CD4 + T cells in a randomised phase 2 trial. NPJ Vaccines 2019; 4:25. [PMID: 31231551 PMCID: PMC6546693 DOI: 10.1038/s41541-019-0117-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/26/2019] [Indexed: 01/21/2023] Open
Abstract
VAC-3S is a therapeutic vaccine comprising a highly conserved HIV-gp41 motif coupled with the CRM197 carrier protein. High levels of anti-3S antibodies (Abs) have been associated with improved protection of CD4+ T-cell survival. A previous phase 1 study demonstrated the safety of VAC-3S. This multicentre, randomised, double-blind, placebo-controlled phase 2 clinical trial enroled between January 2014 and March 2015 HIV-1-infected patients under ART with plasma HIV RNA levels below 50 copies/mL and CD4 counts between 200 and 500 cells/μL. Participants were immunised with 16, 32, or 64 μg of VAC-3S, and compared to placebo. The primary outcome was immunogenicity assessed by changes from baseline of anti-3S Abs levels at week 12. Secondary outcomes included adverse events and the course of plasma HIV RNA level, CD4 count, CD4/CD8 ratio, inflammation and immune checkpoints from week 0 to week 48. Vaccination was well tolerated with no serious adverse events and induced a significant increase in anti-3S Ab response in vaccinated patients (p < 0.0001), compared to placebo. In high responders, the robust increased of CD4 count was associated with a significant and sustained reduction of PD-1 expression on CD4+ T cells through week 48 (variance p = 0.0017). PD-1 expression was correlated with level of anti-3S Abs (p = 0.0092, r = −0.68) and expression of NKp44L (p < 0.0001; r = 0.54) in CD4+ T cells. Our findings regarding the increase of non-exhausted CD4+ T cells have potentially important application in personalised HIV vaccination for HIV-infected patients with high level of PD-1 to improve their T-cell immune function.
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Affiliation(s)
- Vincent Vieillard
- 1Sorbonne Université, Inserm, CNRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Béhazine Combadière
- 1Sorbonne Université, Inserm, CNRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Roland Tubiana
- 2AP-HP Pitié-Salpêtrière, Paris, France.,3Sorbonne Université, UPMC Univ Paris 06, Inserm, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | | | | | - Laurent Cotte
- 6Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France
| | | | - Anne Simon
- 2AP-HP Pitié-Salpêtrière, Paris, France.,3Sorbonne Université, UPMC Univ Paris 06, Inserm, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | | | - Jacques Reynes
- 8Hôpital Gui de Chauliac, Montpellier, France.,9Unité Mixte Internationale "TransVIHMI", IRD UMI233, Inserm U1175, Université de Montpellier, Montpellier, France
| | | | | | | | - Alain Devidas
- 13Centre hospitalier Sud Francilien, Corbeil-Essonne, France
| | | | - Laurence Weiss
- 15AP-HP Hôpital Européen Georges Pompidou, Paris, France.,Université Paris Descartes, Sorbonne Paris-Cité; Inserm, Paris, France
| | - Gerd Fätkenheuer
- 17Department 1 for Internal Medicine, University Hospital of Cologne, Cologne, Germany.,German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany
| | - Brigitte Autran
- 1Sorbonne Université, Inserm, CNRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France.,2AP-HP Pitié-Salpêtrière, Paris, France
| | | | - Shahin Gharakhanian
- Pharmaceutical Medicine & Infectious Diseases, CIC: Cambridge Innovation Center, Cambridge, MA USA
| | - Patrice Debré
- 1Sorbonne Université, Inserm, CNRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France.,2AP-HP Pitié-Salpêtrière, Paris, France
| | - Christine Katlama
- 2AP-HP Pitié-Salpêtrière, Paris, France.,3Sorbonne Université, UPMC Univ Paris 06, Inserm, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
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