HIV-neutralizing immunoglobulin A and HIV-specific proliferation are independently associated with reduced HIV acquisition in Kenyan sex workers

被引:82
作者
Hirbod, Taha [2 ]
Kaul, Rupert [3 ,5 ,6 ]
Reichard, Camilla [2 ]
Kimani, Joshua [3 ]
Ngugi, Elizabeth [4 ]
Bwayo, Job J. [3 ]
Nagelkerke, Nico [7 ,8 ]
Hasselrot, Klara [2 ]
Li, Bing [5 ]
Moses, Stephen [9 ]
MacDonald, Kelly S. [1 ,5 ]
Broliden, Kristina [2 ]
机构
[1] Mt Sinai Hosp, Dept Microbiol, Toronto, ON M5G 1X5, Canada
[2] Karolinska Univ Hosp, Karolinska Inst, Ctr Mol Med, Dept Med,Infect Dis Unit, Solna, Sweden
[3] Univ Nairobi, Dept Med Microbiol, Nairobi, Kenya
[4] Univ Nairobi, Dept Community Hlth, Nairobi, Kenya
[5] Univ Toronto, Dept Med, Toronto, ON, Canada
[6] Univ Hlth Network, Dept Med, Toronto, ON, Canada
[7] United Arab Emirates Univ, Dept Community Med, Al Ain, U Arab Emirates
[8] Univ Manitoba, Dept Med Microbiol, Winnipeg, MB, Canada
[9] Univ Manitoba, Dept Community Hlth Sci & Med, Winnipeg, MB, Canada
关键词
cellular proliferation; exposed uninfected; HIV; immunoglobulin A; neutralization;
D O I
10.1097/QAD.0b013e3282f56b64
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Objectives: HIV-neutralizing immunoglobulin A (IgA) and HIV-specific cellular immunity have been described in highly exposed, persistently seronegative (HEPS) individuals, but well controlled studies have not been performed. We performed a prospective, nested case-control study to examine the association of genital IgA and systemic cellular immune responses with subsequent HIV acquisition in high-risk Kenyan female sex workers (FSWs). Design and methods: A randomized trial of monthly antibiotic prophylaxis to prevent sexually transmitted disease/HIV infection was performed from 1998 to 2002 in HIV-uninfected Kenyan FSWs. After the completion of trial, FSWs who had acquired HIV (cases) were matched 1 : 4 with persistently uninfected controls based on study arm, duration of HIV-seronegative follow-up, and time of cohort enrolment. Blinded investigators assayed the ability at enrolment of genital IgA to neutralize primary HIV isolates as well as systemic HIV-specific cellular IFN gamma-modified enzyme-linked immunospot and proliferative responses. Results: The study cohort comprised 113 FSWs: 24 cases who acquired HIV and 89 matched controls. Genital HIV-neutralizing IgA was associated with reduced HIV acquisition (P= 0.003), as was HIV-specific proliferation (P= 0.002), and these associations were additive. HIV-specific IFN gamma production did not differ between case and control groups. In multivariable analysis, HIV-neutralizing IgA and HIV-specific proliferation each remained independently associated with lack of HIV acquisition. Genital herpes (HSV2) was associated with increased HIV risk and with reduced detection of HIV-neutralizing IgA. Conclusion: Genital HIV-neutralizing IgA and systemic HIV-specific proliferative responses, assayed by blinded investigators, were prospectively associated with HIV nonacquisition. The induction of these immune responses may be an important goal for HIV vaccines. (C) 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins.
引用
收藏
页码:727 / 735
页数:9
相关论文
共 41 条
[1]   LOGIT-MODELS FOR SETS OF RANKED ITEMS [J].
ALLISON, PD ;
CHRISTAKIS, NA .
SOCIOLOGICAL METHODOLOGY 1994, VOL 24, 1994, 24 :199-228
[2]   Human neutralizing monoclonal antibodies of the IgG1 subtype protect against mucosal simian-human immunodeficiency virus infection [J].
Baba, TW ;
Liska, V ;
Hofmann-Lehmann, R ;
Vlasak, J ;
Xu, WD ;
Ayehunie, S ;
Cavacini, LA ;
Posner, MR ;
Katinger, H ;
Stiegler, G ;
Bernacky, BJ ;
Rizvi, TA ;
Schmidt, R ;
Hill, LR ;
Keeling, ME ;
Lu, YC ;
Wright, JE ;
Chou, TC ;
Ruprecht, RM .
NATURE MEDICINE, 2000, 6 (02) :200-206
[3]   HIV nonprogressors preferentially maintain highly functional HIV-specific CD8+ T cells [J].
Betts, Michael R. ;
Nason, Martha C. ;
West, Sadie M. ;
De Rosa, Stephen C. ;
Migueles, Stephen A. ;
Abraham, Jonathan ;
Lederman, Michael M. ;
Benito, Jose M. ;
Goepfert, Paul A. ;
Connors, Mark ;
Roederer, Mario ;
Koup, Richard A. .
BLOOD, 2006, 107 (12) :4781-4789
[4]   Comprehensive cross-clade neutralization analysis of a panel of anti-human immunodeficiency virus type 1 monoclonal antibodies [J].
Binley, JA ;
Wrin, T ;
Korber, B ;
Zwick, MB ;
Wang, M ;
Chappey, C ;
Stiegler, G ;
Kunert, R ;
Zolla-Pazner, S ;
Katinger, H ;
Petropoulos, CJ ;
Burton, DR .
JOURNAL OF VIROLOGY, 2004, 78 (23) :13232-13252
[5]   VIROLOGICAL AND IMMUNOLOGICAL CHARACTERIZATION OF LONG-TERM SURVIVORS OF HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 INFECTION [J].
CAO, YZ ;
QIN, LM ;
ZHANG, LQ ;
SAFRIT, J ;
HO, DD .
NEW ENGLAND JOURNAL OF MEDICINE, 1995, 332 (04) :201-208
[6]   Mucosal and plasma IgA from HIV-1-exposed uninfected individuals inhibit HIV-1 transcytosis across human epithelial cells [J].
Devito, C ;
Broliden, K ;
Kaul, R ;
Svensson, L ;
Johansen, K ;
Kiama, P ;
Kimani, J ;
Lopalco, L ;
Piconi, S ;
Bwayo, JJ ;
Plummer, F ;
Clerici, M ;
Hinkula, J .
JOURNAL OF IMMUNOLOGY, 2000, 165 (09) :5170-5176
[7]   Mucosal and plasma IgA from HIV-exposed seronegative individuals neutralize a primary HIV-1 isolate [J].
Devito, C ;
Hinkula, J ;
Kaul, R ;
Lopalco, L ;
Bwayo, JJ ;
Plummer, F ;
Clerici, M ;
Broliden, K .
AIDS, 2000, 14 (13) :1917-1920
[8]  
Devito C, 2002, J ACQ IMMUN DEF SYND, V30, P413, DOI [10.1097/01.QAI.0000021664.20213.5A, 10.1097/00042560-200208010-00007]
[9]  
Guevara H, 2002, J ACQ IMMUN DEF SYND, V29, P435, DOI 10.1097/00126334-200204150-00002
[10]   MULTIVARIATE-ANALYSIS FOR MATCHED CASE-CONTROL STUDIES [J].
HOLFORD, TR ;
WHITE, C ;
KELSEY, JL .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 1978, 107 (03) :245-256