Evaluation of VZV-Specific Cell-Mediated Immunity in Adults Infected With HIV-1 by Using a Simple IFN-γRelease Assay
Evaluation of VZV-Specific Cell-Mediated Immunity in Adults Infected With HIV-1 by Using a Simple IFN-γRelease Assay
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使用简单的 IFN-γ 释放测定评估感染 HIV-1 的成人中 VZV 特异性细胞介导的免疫
作者：
Watanabe D;Otani N;Suzuki S;Dohi H;Hirota K;Yonemoto H;Koizumi Y;Otera H;Yajima K;Nishida Y;Uehira T;Shima M;Shirasaka T;Okuno T
带状疱疹的发生与水痘带状疱疹病毒（VZV）特异性细胞介导的免疫（CMI）反应减少有关。在本研究中，通过测量全血中响应紫外线灭活VZV减毒活疫苗刺激的IFN-γ产生水平，评价了42例抗VZV-IgG抗体阳性HIV-1感染成人中的VZV特异性CMI反应。所有患者中VZV特异性IFN-γ产生水平的中位数为63 pg/ml。与A、B类患者和接受抗逆转录病毒治疗的患者相比，未接受过抗逆转录病毒治疗（ART）的艾滋病定义疾病患者（HIV分类C类）的IFN-γ产生显著降低（分别为P= 0.0194和P = 0.0046）。与从未复发VZV疾病的患者相比，复发VZV疾病发作1个月内和发作1年以上的患者的IFN-γ产生显著增加（分别为P= 0.0396和P = 0.0484）。在多变量分析中，C类和复发性VZV疾病史是影响IFN-γ产生的重要因素。在7名没有复发VZV疾病史的ART初治患者中，在ART前后测量了IFN-γ水平，未观察到显著变化。结果表明，VZV特异性CMI反应在患有AIDS定义疾病的患者中减少，在具有复发性VZV疾病史的患者中增强，但单独使用ART不会增强。可能需要接种疫苗以抑制接受ART的患者中带状疱疹的发展;这种IFN-γ释放测定是一种用于在临床环境中评估VZV特异性CMI反应的有用方法。85：1313-1320，2013.© 2013 Wiley Periodicals，Inc.
The development of herpes zoster is associated with reduced varicella zoster virus (VZV)‐specific cell‐mediated immune (CMI) reactions. In this study, VZV‐specific CMI reactions in 42 anti‐VZV‐IgG antibody‐positive adults infected with HIV‐1 were evaluated by measuring the IFN‐γ production levels in whole blood in response to stimulation with ultraviolet light‐inactivated live attenuated VZV vaccine. The median VZV‐specific IFN‐γ production level in all patients was 63 pg/ml. Antiretroviral therapy (ART)‐naïve patients with an AIDS‐defining illness (HIV classification category C) had significantly lower IFN‐γ production than ART‐naïve patients in categories A and B and patients receiving ART (P= 0.0194 andP= 0.0046, respectively). IFN‐γ production increased significantly in patients within 1 month of the onset of recurrent VZV disease and at more than 1 year from onset, compared with patients who had never had recurrent VZV disease (P= 0.0396 andP= 0.0484, respectively). In multivariate analyses, category C and history of recurrent VZV disease were significant factors affecting IFN‐γ production. Levels of IFN‐γ were measured before and after ART in seven ART‐naïve patients with no history of recurrent VZV disease, and no significant changes were observed. The results indicate that VZV‐specific CMI reactions were reduced in patients with an AIDS‐defining illness and enhanced in patients with a history of recurrent VZV disease, but not enhanced by ART alone. Vaccination may be necessary to inhibit the development of herpes zoster in patients receiving ART; this IFN‐γ releasing assay is one useful method for evaluating VZV‐specific CMI reactions in clinical settings.J. Med. Virol. 85:1313–1320, 2013. © 2013 Wiley Periodicals, Inc.