Document Detail


Restoration of anti-tetanus toxoid responses in patients initiating highly active antiretroviral therapy with or without a boost immunization: an INITIO substudy.
MedLine Citation:
PMID:  18410636     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INITIO is an open-labelled randomized trial evaluating first-line therapeutic strategies for human immunodeficiency virus-1 (HIV-1) infection. In an immunology substudy a tetanus toxoid booster (TTB) immunization was planned for 24 weeks after initiation of highly active antiretroviral therapy (HAART). All patients had received tetanus toxoid immunization in childhood. Generation of proliferative responses to tetanus toxoid was compared in two groups of patients, those receiving a protease inhibitor (PI)-sparing regimen (n = 21) and those receiving a PI-containing (n = 54) regimen. Fifty-two participants received a TTB immunization [PI-sparing (n = 15), PI-containing (n = 37)] and 23 participants did not [PI-sparing (n = 6) or PI-containing (n = 17)]. Cellular responses to tetanus antigen were monitored by lymphoproliferation at time of immunization and every 24 weeks to week 156. Proportions with a positive response (defined as stimulation index > or = 3 and Delta counts per minute > or = 3000) were compared at weeks 96 and 156. All analyses were intent-to-treat. Fifty-two participants had a TTB immunization at median 25 weeks; 23 patients did not. At weeks 96 and 156 there was no evidence of a difference in tetanus-specific responses, between those with or without TTB immunization (P = 0.2, P = 0.4). There was no difference in the proportion with response between those with PI-sparing or PI-containing regimens at both time-points (P = 0.8, P = 0.7). The proliferative response to tetanus toxoid was unaffected by initial HAART regimen. Anti-tetanus responses appear to reconstitute eventually in most patients over 156 weeks when treated successfully with HAART, irrespective of whether or not a TTB immunization has been administered.
Authors:
C T Burton; R L Goodall; A Samri; B Autran; A D Kelleher; G Poli; G Pantaleo; F M Gotch; N Imami;
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical and experimental immunology     Volume:  152     ISSN:  1365-2249     ISO Abbreviation:  Clin. Exp. Immunol.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-15     Completed Date:  2008-06-04     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  0057202     Medline TA:  Clin Exp Immunol     Country:  England    
Other Details:
Languages:  eng     Pagination:  252-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Anti-HIV Agents / therapeutic use*
Antiretroviral Therapy, Highly Active
CD4 Lymphocyte Count
Cell Proliferation
HIV Infections / drug therapy,  immunology*,  virology
HIV-1 / isolation & purification*
Humans
Immunity, Cellular
Immunization
Immunization, Secondary
Lymphocyte Activation / immunology
Tetanus Toxoid / immunology*
Viral Load
Grant Support
ID/Acronym/Agency:
G0501957//Medical Research Council
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/Tetanus Toxoid
Comments/Corrections

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