CD4/CD8 Ratio Predicts Yellow Fever Vaccine-Induced Antibody Titers in Virologically Suppressed HIV-Infected Patients

Author(s):Show less -

Avelino-Silva, Vivian Iida ^[1] ; Miyaji, Karina Takesaki ^[1] ; Mathias, Augusto ^[2] ; Costa, Dayane Alves ^[2] ; de Carvalho Dias, Juliana Zanatta ^[2] ; Lima, Sheila Barbosa ^[3] ; Simoes, Marisol ^[3] ; Freire, Marcos S. ^[3] ; Caiaffa-Filho, Helio H. ^{[4, 5]} ; Hong, Marisa A. ^{[2, 4]} ; Lopes, Marta H. ^[1] ; Sartori, Ana M. ^[1] ; Kallas, Esper G. ^{[2, 1]}

Affiliation

^[1] Univ Sao Paulo, Sch Med, Dept Infect & Parasit Dis, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Sch Med, Div Clin Immunol & Allergy, Sao Paulo - Brazil

^[3] Fundacao Oswaldo Cruz Biomanguinhos, Rio De Janeiro - Brazil

^[4] Adolfo Lutz Inst, Sao Paulo - Brazil

^[5] Univ Sao Paulo, Sch Med, Lab Med Invest LIM 3, Sao Paulo - Brazil

• Document type: Journal article
• Source: JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES; v. 71, n. 2, p. 189-195, FEB 1 2016.
• Web of Science Citations: 6

Abstract

Background:Yellow fever vaccine (YFV) induces weaker immune responses in HIV-infected individuals. However, little is known about YFV responses among antiretroviral-treated patients and potential immunological predictors of YFV response in this population.Methods:We enrolled 34 antiretroviral therapy (ART)-treated HIV-infected and 58 HIV-uninfected adults who received a single YFV dose to evaluate antibody levels and predictors of immunity, focusing on CD4(+) T-cell count, CD4(+)/CD8(+) ratio, and Human Pegivirus (GBV-C) viremia. Participants with other immunosuppressive conditions were excluded.Results:Median time since YFV was nonsignificantly shorter in HIV-infected participants than in HIV-uninfected participants (42 and 69 months, respectively, P = 0.16). Mean neutralizing antibody (NAb) titers was lower in HIV-infected participants than HIV-uninfected participants (3.3 vs. 3.6 log(10)mIU/mL, P = 0.044), a difference that remained significant after adjustment for age, sex, and time since vaccination (P = 0.024). In HIV-infected participants, lower NAb titers were associated with longer time since YFV (rho: -0.38, P = 0.027) and lower CD4(+)/CD8(+) ratio (rho: 0.42, P = 0.014), but not CD4(+) T-cell count (P = 0.52). None of these factors were associated with NAb titers in HIV-uninfected participant. GBV-C viremia was not associated with difference in NAb titers overall or among HIV-infected participants.Conclusions:ART-treated HIV-infected individuals seem to have impaired and/or less durable responses to YFV than HIV-uninfected individuals, which were associated with lower CD4(+)/CD8(+) ratio, but not with CD4(+) T-cell count. These results supports the notion that low CD4(+)/CD8(+) ratio, a marker linked to persistent immune activation, is a better indicator of functional immune disturbance than CD4(+) T-cell count in patients with successful ART. (AU)

• FAPESP's process: 13/05246-8 - IMPACT OF INCIDENT INFECTION BY GBV-C IN CELL ACTIVATION IN PEOPLE LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS (HIV).
• Grantee: Dayane Alves Costa
• Support Opportunities: Scholarships in Brazil - Doctorate