Smallpox Vaccination and Patients with Human Immunodeficiency Virus Infection or Acquired Immunodeficiency Syndrome

Bartlett, John G.

doi:10.1086/368093

Cited by 27 publications

(9 citation statements)

References 23 publications

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“…In these patients with aquired immunodeficiency syndrome, i.e., impairment of the CD4 + T helper cell compartment, immune responses to other viruses can be compromised. In this regard, AIDS patients with CD4 + T cell counts below 50 cells/mm 3 , when immunized with a recombinant strain of vaccinia virus, were reported with fatal viral complications (Zagury, 1991), consistent with a report on vaccination with replication-competent vaccinia virus (Bartlett, 2003) that resulted in life-threatening infection of a patient with CD4 + T cell counts below 25 cells/mm 3 .…”

Section: Humoral Memory Establishment Is Dependent On T Cell Helpsupporting

confidence: 86%

Antibodies and B Cell Memory in Viral Immunity

2007

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Humoral immunity, in particular secreted neutralizing antibodies, is of central importance to protect the body against acutely cytopathic viruses, whereas noncytopathic viruses have found ways of balanced coexistence with the immune system to avoid antibody-mediated elimination. There is evidence that polyspecific "natural" antibodies provide early protection, independent of T cell help. If that line of defense is crossed, T cell-dependent immune responses then generate a humoral memory provided by long-lived plasma cells secreting specific antibodies of adapted avidity and function, i.e., isotype, even in the absence of virus. Secreted protective antibodies of humoral memory provide an efficient line of defense against reinfection and are backed up by specific B and T memory cells of reactive memory. Whereas humoral memory has developed effective antiviral protection, some viruses (i.e., HIV) have managed to develop specific evasion strategies to escape it. Thus, coevolution provides us with some insight into just how substantial antiviral antibodies and memory B cell are in protecting the host from virus infection.

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Section: Humoral Memory Establishment Is Dependent On T Cell Helpsupporting

confidence: 86%

Antibodies and B Cell Memory in Viral Immunity

2007

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“…In terms of primary vaccinia infections, T-cell-mediated immunity is very important; when an HIV þ military recruit almost died of disseminated vaccinia following smallpox vaccination in 1984, it was probably due to low T-cell immunity [54]. Retrospective analysis indicates that HIV infection itself is not an absolute death sentence [55] because it is estimated that 300 HIV þ recruits were vaccinated prior to 1990 without any recorded incident [56]. In contrast, when recombinant vaccinia was administered to AIDS patients, 3/8 patients died of complications; all 3 had CD4 þ T-cell counts of <50 cells/mm 3 [57].…”

Section: Duration and Mechanisms Of Protective Immunitymentioning

confidence: 99%

Immunological memory to viral infection

Slifka¹

2004

Current Opinion in Immunology

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“…However, in the absence of large-scale clinical trials the Centers for Disease Control and Prevention (Atlanta, GA) recommended against the use of the replication-competent vaccinia virus to vaccinate individuals with HIV infection, regardless of their CD4 cell counts. 40 Thus, replication-deficient MVA because of its immunogenicity and safety may represent a better alternative. Nevertheless, a series of limitations of the present study need to be emphasized.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Modified Vaccinia Virus Ankara as an Alternative Vaccine against Smallpox in Chronically HIV Type 1-Infected Individuals Undergoing HAART

Cosma¹,

Nagaraj²,

Staib³

et al. 2007

AIDS Research and Human Retroviruses

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The fear of malevolent use of variola virus by terrorists has led to the implementation of a health care worker vaccination program and to the consideration of vaccination for the general public. However, due to concerns about side effects of the classical smallpox vaccine, especially for immunocompromised individuals, a safer vaccine is urgently needed. We characterized the immunogenicity of modified vaccinia virus Ankara (MVA), one of the more promising alternative smallpox vaccines, in a cohort of 10 chronically HIV-1-infected individuals undergoing highly active antiretroviral therapy (HAART). Nine subjects received smallpox vaccination as children while one subject was never vaccinated against smallpox. All the subjects had CD4 counts >400 cells/mm(3) and 8 out of 10 had undetectable viral loads. MVA was able to elicit humoral and cellular immune responses in the majority of individuals. Vaccinia-specific antibodies were mainly of the IgG class while T cells specific to vaccinia were predominantly CD8(+). The immune responses were maintained over 1 year. Similar vaccinia specific humoral immune responses were observed when our cohort of HIV-1-infected individuals was compared to smallpox-vaccinated healthy subjects. The observed immune responses suggest that the highly attenuated MVA could be used as a substitute vaccine against smallpox in chronically HIV-1-infected individuals undergoing HAART.

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Smallpox Vaccination and Patients with Human Immunodeficiency Virus Infection or Acquired Immunodeficiency Syndrome

Cited by 27 publications

References 23 publications

Antibodies and B Cell Memory in Viral Immunity

Antibodies and B Cell Memory in Viral Immunity

Immunological memory to viral infection

Evaluation of Modified Vaccinia Virus Ankara as an Alternative Vaccine against Smallpox in Chronically HIV Type 1-Infected Individuals Undergoing HAART

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