Pasricha Neelam, Datta Usha, Chawla Yogesh, Singh Surjit, Arora Sunil K, Sud Archana, Minz Ranjana W, Saikia Biman, Singh Haqeeqat, James Isaac, Sehgal Shobha
PostGraduate Institute of Medical Education and Research, Chandigarh, India.
Trop Gastroenterol. 2005 Oct-Dec;26(4):178-82.
The study was conducted with an aim to assess the efficacy of recombinant HBV vaccination in untreated HBV seronegative HIV/AIDS subjects as compared to normal controls. The second objective was to identify differences in CD4 and CD8 T cell numbers/kinetics/functions and levels of TH2 cytokines (IL4 and IL10) in different groups during the three-dose vaccination regimen. 40 HIV/AIDS patients were subdivided into groups 1A where patients had a high CD4 (> 200/mm3) count and IB where patients had a low CD4 (< 200/mm3) count. Twenty normal healthy control subjects were also recruited in the study (group II). Patients received 40 micro and controls received 20 micro of recombinant HBV vaccine in each dose. All subjects received 3 doses of the vaccine. Detection of CD4 and CD8 cells was done by flowcytometry. TH2 type of cytokines IL4 and IL10 were estimated in the culture supernatant of PHA stimulated leukocyte rich plasma by sandwich ELISA. Anti-HBs levels were estimated in the serum by ELISA. Anti-HBs response was severely compromised in patients as compared to controls. Groups II, 1A and 1B showed titers of 16906 +/- 21303, 8834 +/- 14136 and 462 +/- 814 m/U/m/ respectively. Both CD4 and CD8 cells increased significantly after vaccination in all the groups irrespective of the disease status. On the other hand, IL4/IL10 responses to PHA stimulation in the HIV-positive groups were much lower than in controls (P< 0.1). Despite a double dose of vaccine in patients, the antibody response was significantly lower which correlated with a lower CD4 count. Cytokines IL4 and IL10 which regulate antibody response, were also lower in-patients and this together with a low CD4 count possibly accounted for the low anti-HBs levels. All patients with high CD4 lymphocyte count were responders while only 47% of patients with low CD4 lymphocyte count responded to immunization. Patients with a CD4 count of less than 50 failed to respond. Thus early immunization is advocated in all HIV patients at a stage when they are still capable of mounting an adequate immune response.
本研究旨在评估重组乙肝疫苗对未经治疗的乙肝血清学阴性的艾滋病毒/艾滋病患者的疗效，并与正常对照组进行比较。第二个目标是确定在三剂疫苗接种方案期间，不同组中CD4和CD8 T细胞数量/动力学/功能以及TH2细胞因子（IL4和IL10）水平的差异。40名艾滋病毒/艾滋病患者被分为1A组（患者CD4计数高（>200/mm3））和1B组（患者CD4计数低（<200/mm3））。本研究还招募了20名正常健康对照者（II组）。患者每剂接受40微克重组乙肝疫苗，对照组每剂接受20微克。所有受试者均接受3剂疫苗。通过流式细胞术检测CD4和CD8细胞。通过夹心ELISA法在PHA刺激的富含白细胞血浆的培养上清液中估计TH2型细胞因子IL4和IL10。通过ELISA法在血清中估计抗-HBs水平。与对照组相比，患者的抗-HBs反应严重受损。II组、1A组和1B组的滴度分别为16906±21303、8834±14136和462±814 m/U/ml。无论疾病状态如何，所有组接种疫苗后CD4和CD8细胞均显著增加。另一方面，HIV阳性组对PHA刺激的IL4/IL10反应远低于对照组（P<0.1）。尽管患者接种了双倍剂量的疫苗，但其抗体反应仍显著较低，这与较低的CD4计数相关。调节抗体反应的细胞因子IL4和IL10在患者中也较低，这与低CD4计数一起可能是抗-HBs水平低的原因。所有CD4淋巴细胞计数高的患者均有反应，而CD4淋巴细胞计数低的患者只有47%对免疫有反应。CD4计数低于50的患者无反应。因此，建议在所有艾滋病毒患者仍有能力产生充分免疫反应的阶段尽早进行免疫接种。
