PNAS：艾滋病儿童接种疫苗可能成功

科学家报告说，如果出生就感染了艾滋病病毒的儿童在出生的头一年接受高效抗逆转录病毒治疗（HAART），他们就可能成功地接种麻疹和破伤风疫苗。健康儿童的免疫系统在出生的头一年发育，但是感染艾滋病病毒的儿童的免疫系统可能永远都不会充分发育。

Simone Pensieroso及其同事证明了在出生头一年用HAART抑制艾滋病病毒可以让一名儿童发育出免疫接种必需的B细胞防御。这组作者分析了在一组70名出生就感染了艾滋病病毒儿童在接种疫苗后的B细胞数量和针对几种常见病原体的抗体水平，这些儿童或者在出生头一年接受了HAART，或者完全没有。这组作者发现，在出生的头一年——而非之后或永远没有——接受HAART的感染艾滋病病毒的儿童体内，B细胞计数和针对麻疹和破伤风的抗体滴度一直很高——超过了起保护作用所需的限度。这组作者说，这些结果提示，只要艾滋病病毒阳性儿童尽早接受HAART，免疫接种就可以在他们的身上起作用。（生物谷Bioon.com）

生物谷推荐原始出处：

PNAS April 27, 2009, doi: 10.1073/pnas.0901702106

Timing of HAART defines the integrity of memory B cells and the longevity of humoral responses in HIV-1 vertically-infected children

Simone Pensierosoa,b,1, Alberto Cagigia,1, Paolo Palmab,c,1,2, Anna Nilssona,d, Claudia Capponic, Elio Fredab, Stefania Bernardic, Rigmor Thorstenssone, Francesca Chiodia and Paolo Rossib,c

aDepartments of aMicrobiology, Tumor and Cell Biology and
dWomen and Child Health, Karolinska Institutet, Stockholm 171 77, Sweden;
bChair of Pediatrics, Department of Public Health, University of Tor Vergata, Rome 00133, Italy;
cDivision of Immunology and Infectious Diseases, Ospedale Pediatrico “Bambino Gesù,” Rome 00165, Italy; and
eThe Swedish Institute for Infectious Disease Control, Stockholm 171 77, Sweden

Abstract

HIV-1 infection induces a progressive disruption of the B cell compartment impairing long-term immune responses to routine immunizations. Depletion of specific memory B cell pools occurs during the 1st stages of the infection and cannot be reestablished by antiretroviral treatment. We reasoned that an early control of viral replication through treatment could preserve the normal development of the memory B cell compartment and responses to routine childhood vaccines. Accordingly, we evaluated the effects of different highly-active antiretroviral therapy (HAART) schedules in 70 HIV-1 vertically-infected pediatric subjects by B cell phenotypic analyses, antigen-specific B cell enzyme-linked immunosorbent spot (ELISpot) and ELISA for common vaccination and HIV-1 antigens. Initiation of HAART within the 1st year of life permits the normal development and maintenance of the memory B cell compartment. On the contrary, memory B cells from patients treated later in time are remarkably reduced and their function is compromised regardless of viral control. A cause for concern is that both late-treated HIV-1 controllers and noncontrollers loose protective antibody titers against common vaccination antigens. Timing of HAART initiation is the major factor predicting the longevity of B cell responses in vaccinated HIV-1-infected children.

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