Human Immunodeficiency Virus Exposure but Not Early Cytomegalovirus Infection Is Associated With Increased Hospitalization and Decreased Memory T-Cell Responses to Tetanus Vaccine.
Human Immunodeficiency Virus Exposure but Not Early Cytomegalovirus Infection Is Associated With Increased Hospitalization and Decreased Memory T-Cell Responses to Tetanus Vaccine.
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人类免疫缺陷病毒暴露与住院率增加和破伤风疫苗记忆 T 细胞反应降低相关，但与早期巨细胞病毒感染无关。
DOI：
10.1093/infdis/jiz590
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Weinberg,Adriana
中科院分区：
文献类型：
--
作者：
Smith,Christiana;Moraka,NatashaO;Ibrahim,Maryanne;Moyo,Sikhulile;Mayondi,Gloria;Kammerer,Betsy;Leidner,Jean;Gaseitsiwe,Simani;Li,Shaobing;Shapiro,Roger;Lockman,Shahin;Weinberg,Adriana
背景人类免疫缺陷病毒(HIV)暴露的未感染(HEU)婴儿具有较高的感染性发病率。我们假设与未接触HIV的婴儿相比，早期巨细胞病毒(CMV)感染与HEU的住院率增加和疫苗应答率降低有关。方法在博茨瓦纳参加Tshiidi研究的婴儿中，我们确定了6个月大的CMV感染状况，并比较了HEU和HUU疫苗接种者的住院率和对破伤风和卡介苗的反应。结果226名HEU婴儿中有15名(6.6%)和88名HUU婴儿中的17名(19.3%)在6个月时感染了CMV。HEU婴儿住院的可能性大约是HUU婴儿的3倍(P=0.02)。破伤风类毒素刺激后，HEU外周血细胞产生的IL-2减少(P=0.004)，但产生的干扰素-γ相似。两组间抗人血吸虫免疫球蛋白G滴度相似。细胞对纯化蛋白衍生刺激的反应在不同组之间没有差异。与齐多夫定相比，母亲接受3种药物抗逆转录病毒治疗与破伤风类毒素刺激后IL-2表达增加有关。婴儿的巨细胞病毒感染状况与临床或疫苗应答结果无关。结论我们观察到婴儿对破伤风疫苗的住院率增加和记忆T细胞应答降低与HIV暴露和母亲HIV感染治疗不彻底有关，但与早期CMV感染无关。
BackgroundHuman immunodeficiency virus (HIV)-exposed, uninfected (HEU) infants experience high rates of infectious morbidity. We hypothesized that early cytomegalovirus (CMV) infection was associated with increased hospitalization rates and decreased vaccine responses in HEU compared with HIV-unexposed (HUU) infants.MethodsAmong infants enrolled in the Tshipidi study in Botswana, we determined CMV infection status by 6 months of age and compared hospitalization rates and responses to tetanus and Bacille Calmette-Guérin vaccines among HEU and HUU vaccinees.ResultsFifteen of 226 (6.6%) HEU infants and 17 (19.3%) of 88 HUU infants were CMV-infected by 6 months. The HEU infants were approximately 3 times as likely to be hospitalized compared with HUU infants (P= .02). The HEU peripheral blood cells produced less interleukin (IL)-2 (P= .004), but similar amounts of interferon-γ, after stimulation with tetanus toxoid. Antitetanus immunoglobulin G titers were similar between groups. Cellular responses to purified protein derivative stimulation did not differ between groups. Maternal receipt of 3-drug antiretroviral therapy compared with zidovudine was associated with increased IL-2 expression after tetanus toxoid stimulation. The infants’ CMV infection status was not associated with clinical or vaccine response outcomes.ConclusionsWe observed that increased rates of hospitalization and decreased memory T-cell responses to tetanus vaccine were associated with HIV exposure and incomplete treatment of maternal HIV infection, but not early CMV infection.
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