Xu Ling, Zhang Li, Kang Shuang, Li Xiaodi, Lu Lianfeng, Liu Xiaosheng, Song Xiaojing, Li Yanling, Li Xiaoxia, Lyu Wei, Cao Wei, Liu Zhengyin, Li Taisheng
Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Center for AIDS Research, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Vaccines (Basel). 2023 Feb 9;11(2):400. doi: 10.3390/vaccines11020400.
Understanding immune responses after HBV vaccination is important to prevent HBV infection in PLWH and to achieve successful treatment.
Thirty-two PLWHs with CD4 cell count > 350 cells/µL and HIV RNA < 200 copies/mL were vaccinated with 20 µg of HBV vaccine at weeks 0, 4, and 24 in this prospective study. We measured total HIV DNA levels, HBsAb titers and HBsAg-specific T-cell responses during follow-up time.
All patients achieved protective HBsAb titer after immunization. The magnitude of the IFN-r and TNF-a response to HBsAg was 22.0 (IQR: 6.5-65.0) and 106.50 (IQR: 58.5-203.0) spot-forming cells (SFC)/10 PBMC, respectively at week 0. The level of IFN-r secreted at weeks 12 and weeks 36 to 48 was comparable with that at week 0. However, IFN-r response was higher at weeks 12 than that at weeks 36 to 48 ( = 0.02). The level of TNF-a secreted at weeks 12 was higher than that at week 0 ( < 0.001). Total HIV DNA levels were 2.76 (IQR: 2.47-3.07), 2.77 (IQR: 2.50-3.09), 2.77 (IQR: 2.41-2.89) log copies/10 PBMCs at weeks 0, 12, 36 to 48, respectively. No correlation was observed between IFN-r and TNF-a levels and HBsAb titer as well as total HIV DNA levels after immunization.
Humoral immunity was satisfactory, but cellular immunity and decline in HIV reservoir were not optimal after HBV vaccine immunization in these patients.
了解乙肝疫苗接种后的免疫反应对于预防艾滋病毒感染者的乙肝病毒感染以及实现成功治疗至关重要。
在这项前瞻性研究中，32名CD4细胞计数>350个细胞/微升且HIV RNA<200拷贝/毫升的艾滋病毒感染者在第0、4和24周接种了20微克乙肝疫苗。我们在随访期间测量了总HIV DNA水平、乙肝表面抗体（HBsAb）滴度和乙肝表面抗原（HBsAg）特异性T细胞反应。
所有患者免疫后均达到保护性HBsAb滴度。在第0周时，对HBsAg的干扰素-γ（IFN-γ）和肿瘤坏死因子-α（TNF-α）反应强度分别为22.0（四分位间距：6.5-65.0）和106.50（四分位间距：58.5-203.0）斑点形成细胞（SFC）/10个外周血单个核细胞（PBMC）。在第12周以及第36至48周时分泌的IFN-γ水平与第0周时相当。然而，第12周时的IFN-γ反应高于第36至48周时（P = 0.02）。第12周时分泌的TNF-α水平高于第0周时（P<0.001）。在第0、12、36至48周时，总HIV DNA水平分别为2.76（四分位间距：2.47-3.07）、2.77（四分位间距：2.50-3.09）、2.77（四分位间距：2.41-2.89）对数拷贝/10个PBMC。免疫后未观察到IFN-γ和TNF-α水平与HBsAb滴度以及总HIV DNA水平之间存在相关性。
在这些患者中，乙肝疫苗免疫后的体液免疫令人满意，但细胞免疫和艾滋病毒储存库的下降并不理想。
