Cagigi Alberto, Rinaldi Stefano, Cotugno Nicola, Manno Emma Concetta, Santilli Veronica, Mora Nadia, Zangari Paola, Aquilani Angela, Tchidjou Kuekou Hyppolite, Giaquinto Carlo, Bernardi Stefania, Rossi Paolo, Palma Paolo
From the *University Department of Pediatrics, DPUO, Unit of Immune and Infectious Diseases, Bambino Gesù Children's Hospital, Piazza S. Onofrio; †Department of Public Health, University of Rome, Tor Vergata, Rome; and ‡Department of Pediatrics, University of Padova, Padova, Italy.
Pediatr Infect Dis J. 2014 May;33(5):e126-31. doi: 10.1097/INF.0000000000000144.
We have previously reported that an early initiation of highly active antiretroviral therapy (HAART) in HIV-1 vertically infected children enhanced the function of memory B-cells gained during childhood routine vaccinations. On the other hand, a significant waning of immunity was observed for patients with a late treatment. In this follow-up study, we report data from a sample of patients in our cohort including late-treated patients being revaccinated with routine childhood vaccines.
The levels of serum antibodies and cellular immunity were measured by antigen-specific enzyme-linked immunosorbent assay and B-cell ELISpot. Moreover, flow cytometry on the frequencies of mature-activated (CD10-CD21-) and double-negative (CD27-IgD-) B-cells as hallmarks of immune activation and immune senescence, respectively, was performed for all patients.
Reduced protective humoral immunity and cellular immunity to routine childhood vaccines was observed in late-treated patients. Moreover, we found that timing of HAART related with the frequencies of mature activated and double negative.
Altogether the data presented in this follow-up study reenforce the importance for an early start of HAART in HIV-1 vertically infected individuals and suggest that timing of HAART is a fundamental factor to take into account for vaccination design in this population.
我们之前报道过，在垂直感染HIV-1的儿童中早期开始高效抗逆转录病毒治疗（HAART）可增强儿童常规疫苗接种期间获得的记忆B细胞功能。另一方面，观察到晚期治疗患者免疫力显著下降。在这项随访研究中，我们报告了队列中一组患者的数据，包括接受常规儿童疫苗重新接种的晚期治疗患者。
通过抗原特异性酶联免疫吸附测定和B细胞酶联免疫斑点法测量血清抗体水平和细胞免疫。此外，对所有患者进行流式细胞术检测成熟激活（CD10-CD21-）和双阴性（CD27-IgD-）B细胞的频率，分别作为免疫激活和免疫衰老的标志。
在晚期治疗患者中观察到对常规儿童疫苗的保护性体液免疫和细胞免疫降低。此外，我们发现HAART的时机与成熟激活和双阴性的频率有关。
总之，这项随访研究中呈现的数据再次强调了在垂直感染HIV-1的个体中早期开始HAART的重要性，并表明HAART的时机是该人群疫苗接种设计中需要考虑的一个基本因素。
