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用1型人类免疫缺陷病毒重组糖蛋白160免疫AG疫苗对CD4 + T细胞计数≥500和200 - 400/mm3的HIV感染者进行治疗性免疫的效果(艾滋病临床试验组研究246/946)

Effect of therapeutic immunization with HIV type 1 recombinant glycoprotein 160 ImmunoAG vaccine in HIV-infected individuals with CD4+ T cell counts of >or=500 and 200-400/mm3 (AIDS Clinical Trials Group Study 246/946).

作者信息

Kundu-Raychaudhuri S, Sevin A, Kilgo P, Nokta M, Pollard R B, Merigan T C

机构信息

AIDS Clinical Trials Unit, Center for AIDS Research, Stanford University Medical Center, Stanford, California 94305-5107, USA.

出版信息

AIDS Res Hum Retroviruses. 2001 Oct 10;17(15):1371-8. doi: 10.1089/088922201753197033.

Abstract

AIDS Clinical Trials Group (ACTG) 246/946 was a double-blinded, randomized, controlled trial of HIV-1 MN rgp160 ImmunoAG vaccine in HIV-infected patients with CD4(+) T cell counts >or=500 and 200-400/mm(3). The main objectives were to study the safety and immunogenicity of this vaccine and to study the persistence of the immune responses after vaccination over a longer period of time. Fifteen patients with CD4(+) T cell counts of >or=500/mm(3) were enrolled in the ACTG 246 study. ACTG 246 patients received a monthly injection of vaccine or control for 6 months and then injections every 2 months. After completion of this study, seven new patients with CD4(+) T cell counts of 200-400/mm(3) entered into the ACTG 946 study. These study patients received highly active antiretroviral therapy (HAART) (ritonavir, didanosine, and stavudine) for 9 weeks to stabilize their viral load and then each patient received a monthly injection of vaccine or control substance for 6 months with HAART. The study of these two relatively small populations showed that the vaccine was safe without any adverse effect both in the patients with CD4(+) T cell counts of >or=500 and 200-400/mm(3). The vaccine was also immunogenic in patients with CD4(+) T cell counts of >or=500/mm(3) as measured by gp160-specific lymphocyte proliferative responses, and it persisted after they had received more than six vaccine injections, for a longer period of time.

摘要

艾滋病临床试验组(ACTG)246/946是一项双盲、随机、对照试验,研究对象为HIV-1 MN重组gp160免疫原性疫苗用于CD4(+) T细胞计数≥500以及200 - 400/mm(3) 的HIV感染患者。主要目的是研究该疫苗的安全性和免疫原性,并研究接种疫苗后免疫反应在较长时间内的持续性。15名CD4(+) T细胞计数≥500/mm(3) 的患者参与了ACTG 246研究。ACTG 246研究中的患者每月注射一次疫苗或对照物,共6个月,之后每2个月注射一次。该研究完成后,7名新的CD4(+) T细胞计数为200 - 400/mm(3) 的患者进入了ACTG 946研究。这些研究患者接受了9周的高效抗逆转录病毒疗法(HAART)(利托那韦、去羟肌苷和司他夫定)以稳定其病毒载量,然后每位患者在接受HAART的同时每月注射一次疫苗或对照物,共6个月。对这两个相对较小的人群进行的研究表明,该疫苗对于CD4(+) T细胞计数≥500以及200 - 400/mm(3) 的患者而言是安全的,没有任何不良反应。通过gp160特异性淋巴细胞增殖反应测定,该疫苗在CD4(+) T细胞计数≥500/mm(3) 的患者中也具有免疫原性,并且在他们接受超过6次疫苗注射后,这种免疫原性持续了更长时间。

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