Study suggests antiretroviral therapy does not restore disease immunity

January 06, 2020

BROOKLYN, N.Y. (January 6, 2020) - A study led by researchers from SUNY Downstate Health Sciences University and Oregon Health & Science University, published in the Journal of Infectious Diseases1, showed that, despite successful antiretroviral therapy (ART), antigen specific memory to vaccinations that occurred before HIV infection did not recover, even after immune reconstitution. Additionally, a previously unrealized decline in pre-existing antibody response was also observed.

Approximately two-thirds of HIV-positive patients in the U.S. are on an ART regimen. It works by reducing viral replication and boosting CD4 T cell counts, which are important to suppressing or regulating the immune response. Normally, these cells "remember" viruses and respond in large numbers when exposed again.

However, this study suggests that this memory is inhibited in some HIV-positive patients who are otherwise doing well on therapy. Should this loss of serological memory, or HIV-immune associated amnesia, exist for other pre-infection vaccinations or viruses, it would have significant implications for the overall health status of HIV patients, including: "There is no doubt that ART provides significant, life-changing benefits for people with HIV by reconstituting their overall immune response," said Michael Augenbraun, MD, FACP. FIDSA, Professor of Medicine and Vice Chair, Department of Medicine and Director, Division of Infectious Diseases at SUNY Downstate Health Sciences University and Kings County Hospital Center.

"What our study suggests is that ART may not be completely effective in restoring the immune protection resulting from viral infections or childhood vaccines received prior to becoming HIV positive," added Dr. Augenbraun. "This makes these patients potentially susceptible not only to these serious diseases, but also other chronic infections and to chronic inflammation that may diminish their overall health and shorten their lifespan."

Dr. Augenbraun cautions that, while this study only examined immunologic responses to smallpox vaccination and not to specific clinical outcomes, it builds on previous studies and evidence pointing to HIV-associated immune amnesia. He says additional studies need to be conducted both on HIV positive men utilizing the smallpox vaccine antigen, and antigens of other common diseases for which people are vaccinated as children. Additionally, Dr. Augenbraun believes the study may also contribute to gathering support for earlier aggressive treatment in HIV infected individuals before they suffer significant damage to their immune system.

Should future studies identify broader HIV-associated immune amnesia, it could mean that a significant proportion of the 1.1 million people in the U.S. and more than 23 million people worldwide living with HIV have diminished protection from previous immunizations. However, he cautioned that the potential need for revaccination of patients, although suggested by these data, was not directly addressed by the study.
-end-
1 This research was supported by the National Institutes of Health Public Health Service (grant U19 AI109948) and Oregon National Primate Research Center (grant 8P51 OD011092), and other funders.

About SUNY Downstate Health Sciences University:

SUNY Downstate Health Sciences University is the borough's only academic medical center for health education, research, and patient care, and is a 342-bed facility serving the healthcare needs of New York City, and Brooklyn's 2.6 million residents. University Hospital of Brooklyn (UHB) is Downstate's teaching hospital, backed by the expertise of an outstanding medical school and the research facilities of a world-class academic center. More than 800 physicians, representing 53 specialties and subspecialties--many of them ranked as tops in their fields--comprise Downstate's staff.

A regional center for cardiac care, neonatal and high-risk infant services, pediatric dialysis, and transplantation, Downstate also houses a major learning center for children with physical ailments or neurological disorders. In addition to UHB, Downstate comprises a College of Medicine, College of Nursing, School of Health Professions, a School of Graduate Studies, a School of Public Health, and a multifaceted biotechnology initiative, including the Downstate Biotechnology Incubator and BioBAT for early-stage and more mature companies, respectively. For more information, visit http://www.downstate.edu or follow us on Twitter at @sunydownstate

SUNY Downstate Health Science University

Related HIV Articles from Brightsurf:

BEAT-HIV Delaney collaboratory issues recommendations measuring persistent HIV reservoirs
Spearheaded by Wistar scientists, top worldwide HIV researchers from the BEAT-HIV Martin Delaney Collaboratory to Cure HIV-1 Infection by Combination Immunotherapy (BEAT-HIV Collaboratory) compiled the first comprehensive set of recommendations on how to best measure the size of persistent HIV reservoirs during cure-directed clinical studies.

The Lancet HIV: Study suggests a second patient has been cured of HIV
A study of the second HIV patient to undergo successful stem cell transplantation from donors with a HIV-resistant gene, finds that there was no active viral infection in the patient's blood 30 months after they stopped anti-retroviral therapy, according to a case report published in The Lancet HIV journal and presented at CROI (Conference on Retroviruses and Opportunistic Infections).

Children with HIV score below HIV-negative peers in cognitive, motor function tests
Children who acquired HIV in utero or during birth or breastfeeding did not perform as well as their peers who do not have HIV on tests measuring cognitive ability, motor function and attention, according to a report published online today in Clinical Infectious Diseases.

Efforts to end the HIV epidemic must not ignore people already living with HIV
Efforts to prevent new HIV transmissions in the US must be accompanied by addressing HIV-associated comorbidities to improve the health of people already living with HIV, NIH experts assert in the third of a series of JAMA commentaries.

The Lancet HIV: Severe anti-LGBT legislations associated with lower testing and awareness of HIV in African countries
This first systematic review to investigate HIV testing, treatment and viral suppression in men who have sex with men in Africa finds that among the most recent studies (conducted after 2011) only half of men have been tested for HIV in the past 12 months.

The Lancet HIV: Tenfold increase in number of adolescents on HIV treatment in South Africa since 2010, but many still untreated
A new study of more than 700,000 one to 19-year olds being treated for HIV infection suggests a ten-fold increase in the number of adolescents aged 15 to 19 receiving HIV treatment in South Africa, according to results published in The Lancet HIV journal.

Starting HIV treatment in ERs may be key to ending HIV spread worldwide
In a follow-up study conducted in South Africa, Johns Hopkins Medicine researchers say they have evidence that hospital emergency departments (EDs) worldwide may be key strategic settings for curbing the spread of HIV infections in hard-to-reach populations if the EDs jump-start treatment and case management as well as diagnosis of the disease.

NIH HIV experts prioritize research to achieve sustained ART-free HIV remission
Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The Lancet HIV: PrEP implementation is associated with a rapid decline in new HIV infections
Study from Australia is the first to evaluate a population-level roll-out of pre-exposure prophylaxis (PrEP) in men who have sex with men.

Researchers date 'hibernating' HIV strains, advancing BC's leadership in HIV cure research
Researchers have developed a novel way for dating 'hibernating' HIV strains, in an advancement for HIV cure research.

Read More: HIV News and HIV Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.