CD4/CD8 Ratio Predicts Yellow Fever Vaccine-Induced Antibody Titers in Virologically Suppressed HIV-Infected Patients. (1st February 2016)

• Record Type: Journal Article
• Authors: Avelino-Silva, Vivian Iida; Miyaji, Karina Takesaki; Mathias, Augusto; Costa, Dayane Alves; de Carvalho Dias, Juliana Zanatta; Lima, Sheila Barbosa; Simoes, Marisol; Freire, Marcos S.; Caiaffa-Filho, Helio H.; Hong, Marisa A.; Lopes, Marta H.; Sartori, Ana M.; Kallas, Esper G.
• Is Part Of: Journal of acquired immune deficiency syndromes. Volume 71:Number 2(2016)
• Publication Date: 2016-02-01
• Subjects: yellow fever vaccine -- yellow fever neutralizing antibodies -- HIV -- CD4+/CD8+ ratio -- immune activation; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome -- Periodicals; AIDS (Disease); Periodicals; 616.9792005
• DOI: 10.1097/QAI.0000000000000845
• Languages: English
• ISSNs: 1525-4135

Abstract

Abstract : Background: Yellow fever vaccine (YFV) induces weaker immune responses in HIV-infected individuals. However, little is known about YFV responses among antiretroviral-treated patients and potential immunological predictors of YFV response in this population. Methods: We enrolled 34 antiretroviral therapy (ART)-treated HIV-infected and 58 HIV-uninfected adults who received a single YFV dose to evaluate antibody levels and predictors of immunity, focusing on CD4 + T-cell count, CD4 + /CD8 + ratio, and Human Pegivirus (GBV-C) viremia. Participants with other immunosuppressive conditions were excluded. Results: Median time since YFV was nonsignificantly shorter in HIV-infected participants than in HIV-uninfected participants (42 and 69 months, respectively, P = 0.16). Mean neutralizing antibody (NAb) titers was lower in HIV-infected participants than HIV-uninfected participants (3.3 vs. 3.6 log10 mIU/mL, P = 0.044), a difference that remained significant after adjustment for age, sex, and time since vaccination ( P = 0.024). In HIV-infected participants, lower NAb titers were associated with longer time since YFV (rho: −0.38, P = 0.027) and lower CD4 + /CD8 + ratio (rho: 0.42, P = 0.014), but not CD4 + T-cell count ( P = 0.52). None of these factors were associated with NAb titers in HIV-uninfected participant. GBV-C viremia was not associated with difference in NAb titers overall or among HIV-infected participants. Conclusions: ART-treated HIV-infected individuals seem to have impaired and/or less durable responses to YFV than HIV-uninfected individuals, which were associated with lower CD4 + /CD8 + ratio, but not with CD4 + T-cell count. These results supports the notion that low CD4 + /CD8 + ratio, a marker linked to persistent immune activation, is a better indicator of functional immune disturbance than CD4 + T-cell count in patients with successful ART.