ANTIBODY-RESPONSE TO DIPHTHERIA, TETANUS, AND POLIOMYELITIS VACCINES IN RELATION TO THE NUMBER OF CD4(+) T-LYMPHOCYTES IN ADULTS INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS

A prospective study of antibody production by adults infected with human immunodeficiency virus (HIV) after vaccination with T lymphocyte-dependent diphtheria toroid, tetanus toroid, and inactivated trivalent poliovirus vaccine was conducted. Individuals were divided into three groups according to CD4(+) T-lymphocyte count: group 1 had a count of less than or equal to 100 X 10(6)/L; group 2, 101-300 X 10(6)/L; and group 3, >300 X 10(6)/L. After vaccination, 61%, 70%, and 73% of the individuals in groups 1, 2, and 3, respectively, developed protective titers of antibody to diphtheria toxin; the mean postvaccination antibody titer of HIV-infected individuals was significantly lower than that of healthy controls not infected with HIV. Furthermore, the mean titers of antibodies to tetanus toxin and poliovirus were significantly lower in HIV-infected individuals with CD4(+) lymphocyte counts of <300 X 10(6)/L than in controls. Of the HN-infected vaccinees, 83%-100% were protected against tetanus and 78%-100% against polio. We conclude that HIV-infected individuals with CD4(+) lymphocyte counts of <300 x 10(6)/L have an impaired (secondary) antibody response after receipt of T lymphocyte-dependent vaccines.