期刊
HIV MEDICINE
卷 18, 期 5, 页码 321-331出版社
WILEY
DOI: 10.1111/hiv.12432
关键词
cancer; combination antiretroviral therapy; HIV; human papillomavirus; human papillomavirus-specific immune responses; immune recovery
资金
- Ministry of Higher Education, Malaysia, through a High Impact Research/Ministry of Higher Education Grant [UM.C/625/1/HIR, E-000001-20001]
- University of Malaya [UMRG RP029A-14HTM]
ObjectivesHuman papillomavirus (HPV)-associated cancers disproportionately affect those infected with HIV despite effective combination antiretroviral therapy (cART). The primary aim of this study was to quantify HPV16 and HPV52 E6-specific interferon (IFN)- enzyme-linked immunospot (ELISPOT) T-cell responses, a correlate of protective immunity, in the first year following cART initiation and subsequently in those patients with suboptimal (sIR) and optimal (oIR) immune reconstitution. MethodsNinety-four HIV-infected patients were recruited to the study; a longitudinal cohort of patients recruited just prior to commencing cART and followed up for 48 weeks (n = 27), and a cross-sectional cohort (n = 67) consisting of patients with sIR (CD4 T-cell count < 350 cells/L) and oIR (CD4 T-cell count > 500 cells/L) after a minimum of 2 years on cART. Controls (n = 29) consisted of HIV-negative individuals. IFN- ELISPOT responses against HPV16 and HPV52 E6 were correlated to clinical characteristics, anal and oral HPV carriage, T-cell maturational subsets, markers of activation, senescence and T-regulatory cells. ResultsHPV16 and HPV52 E6-specific T-cell responses were detected in only one of 27 patients (3.7%) during the initial phase of immune recovery. After at least 2 years of cART, those who achieved oIR had significantly higher E6-specific responses (9 of 34; 26.5%) compared with those with sIR (2 of 32; 6.3%) (P = 0.029). Apart from higher CD4 T-cell counts and lower CD4 T-cell activation, no other immunological correlates were associated with the detection of HPV16 and HPV52 E6-specific responses. ConclusionsHPV16 and HPV52 E6-specific IFN- T-cell responses, a correlate of protective immunity, were detected more frequently among HIV-infected patients who achieved optimal immune recovery on cART (26.5%) compared with those with suboptimal recovery (6.3%).
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