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Abstract
EFFECT OF IL-2 ON RESPONSES TO HIV AND TETANUS IMMUNIZATION: RESULTS OF ACTG 5046S
VALDEZ H, MITSUYASU R, SAHNER D, MOSS R, LANDAY A, SEVIN A, LEDERMAN M
Background: strong lymphocyte proliferative responses (LPR) to HIV antigens, associated with control of HIV replication, are rarely restored in patients starting HAART during chronic infection. ACTG 5046 examined the effects of IL-2 administration on responses to HIV and tetanus immunization.
Methods: 38 patients with viral loads (VL) below 2000 c/mL after 60 weeks of HAART or HAART+IL-2 enrolled. They received Remune (3 times 2 months apart) and tetanus toxoid (twice 2 months apart). We measured LPR and delayed-type hypersensitivity responses (DTHR). A LPR was: stimulation index (SI) >3 and at least 3x baseline. DTHR: induration >5 mm and at least 5 mm > than baseline.
Results: Time on HAART: 98 weeks; IL-2 group (25 of 38) received 10 IL-2 cycles. Pretherapy CD4+ (221 vs. 242) and CD8+ (458 vs. 446) counts were comparable between groups; the IL-2 group had higher CD4+ (865 vs. 444, p= 0.02) and CD8+ (969 vs. 718, p< 0.03) counts at immunization. Pretherapy VL tended to be higher in IL-2 group (4.6 vs. 3.7, p=0.06), but VL was similar at immunization. The percentage of tetanus responders was similar between groups. At 24 weeks median SI and proportion of responders to HIV were higher in controls (5 vs. 1.6, p=0.003, 63% vs. 27%, p=0.01). DTHR to HIV was larger at weeks 8 and 16 in controls (8 mm vs. 0 mm, p=0.05 and 11 mm vs. 0 mm, p=0.01); more controls had a DTHR to HIV any time after immunization (77% vs. 36%, p=0.05). Higher CD4+ cells (316 vs. 238, p=0.2) before HAART and higher percentage of naïve CD4+ cells (56% vs. 41%, p=0.03) at immunization were found in those with LPR to HIV antigens.
Conclusions: A minority of patients who start HAART with moderately advanced HIV disease mount strong LPR to HIV antigens after Remune. CD4 preservation before HAART and percentage of naïve CD4+ cells at immunization determines the ability to respond. Despite increasing the number of circulating CD4+ cells, IL-2 does not improve responses to immunization.
The 1st. IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
108
Suggested Citation
"VALDEZH, et al.
EFFECT OF IL-2 ON RESPONSES TO HIV AND TETANUS IMMUNIZATION: RESULTS OF ACTG 5046S.
Oral Presentation:
The 1st. IAS Conference on HIV Pathogenesis and Treatment
:
Abstract no.
108"
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