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Lower viral loads and slower CD4 decline in MRKAd5 HIV-1 vaccinees expressing disease-susceptible HLA-B*58:02

Abstract:

Background. HLA strongly influences HIV-1 disease progression. A major contributory mechanism is via the particular HLA-presented HIV-1 epitopes that are recognized by CD8+ T-cells. Different populations vary considerably in the HLA alleles expressed. We investigated the HLA-specific impact of the MRKAd5 HIV-1 Gag/Pol/Nef vaccine in a subset of the infected Phambili cohort in whom the disease-susceptible HLA-B*58:02 is highly prevalent.

Methods. Viral loads, CD4 counts and ELISPOT anti-HIV-1 CD8+ T-cell responses for a subset of infected ART-naïve Phambili participants, selected according to sample availability, were analyzed.

Results. Among those expressing disease-susceptible HLA-B*58:02, vaccinees had a lower chronic viral setpoint than placebo-recipients (median 7,240 versus 122,500 copies/ml, p=0.01), a 0.76log10 lower longitudinal viremia (p=0.01), and slower progression to CD4andLT;350 cells/mm3 (p=0.02). These differences were accompanied by higher Gag-specific breadth (4.5 versus 1 responses, p=0.04) and magnitude (2,300 versus 70 SFC/106 PBMC, p=0.06) in vaccinees versus placebo-recipients.

Conclusions. In addition to the known enhancement of HIV-1 acquisition resulting from the MRKAd5 HIV-1 vaccine, these findings in a non-randomized subset of enrolees show an HLA-specific vaccine effect on time to CD4 decline and viremia post-infection and the potential for vaccines to differentially alter disease outcome according to population HLA composition. (Registration: NCT00413725, DOH-27-0207-1539.)

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1093/infdis/jiw093

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Paediatrics
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Paediatrics
Role:
Author


Publisher:
Oxford University Press
Journal:
Journal of Infectious Diseases More from this journal
Volume:
214
Issue:
3
Pages:
379–389
Publication date:
2016-03-06
Acceptance date:
2016-03-02
DOI:
EISSN:
1537-6613
ISSN:
0022-1899


Keywords:
Pubs id:
pubs:614289
UUID:
uuid:06e81c55-11a1-42b9-8bf5-594d9fdc2d03
Local pid:
pubs:614289
Source identifiers:
614289
Deposit date:
2016-04-08
ARK identifier:

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