Kaposi sarcoma herpes virus antibody response and viremia following highly active antiretroviral therapy in the Swiss HIV Cohort study

被引:21
作者
Sullivan, Sheena G. [1 ,2 ]
Hirsch, Hans H. [3 ]
Franceschi, Silvia [1 ]
Steffen, Ingrid [3 ]
El Amari, Emmanuelle Boffi [4 ]
Mueller, Nicolas J. [5 ]
Magkouras, Ioannis [6 ]
Biggar, Robert J. [1 ]
Rickenbach, Martin [7 ]
Clifford, Gary M. [1 ]
机构
[1] Int Agcy Res Canc, F-69372 Lyon 08, France
[2] Univ Calif Los Angeles, Dept Epidemiol, Los Angeles, CA USA
[3] Univ Basel, Inst Med Microbiol, Basel, Switzerland
[4] Univ Hosp Geneva, Geneva, Switzerland
[5] Univ Zurich Hosp, Div Infect Dis & Hosp Epidemiol, CH-8091 Zurich, Switzerland
[6] Univ Bern, Inst Infect Dis, Bern, Switzerland
[7] Swiss HIV Cohort Study, Coordinat & Data Ctr, Lausanne, Switzerland
基金
瑞士国家科学基金会;
关键词
epidemiology; HAART; HIV/AIDS; Kaposi sarcoma; Kaposi sarcoma herpes virus/human herpesvirus 8; men having sex with men; viral load; HUMAN-IMMUNODEFICIENCY-VIRUS; RISK-FACTORS; HOMOSEXUAL-MEN; HUMAN-HERPESVIRUS-8; INFECTION; IMMUNE-RESPONSES; HHV-8; UNITED-STATES; CANCER-RISK; VIRAL LOAD; AIDS;
D O I
10.1097/QAD.0b013e32833b7830
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Objective: To describe the effect of HAART on Kaposi sarcoma herpes virus (KSHV) antibody response and viremia among HIV-positive MSM. Design: A follow-up study of 272 HIV-positive MSM (including 22 with Kaposi sarcoma) who first initiated HAART between January 1996 and July 2004 in the Swiss HIV Cohort Study. Methods: For each individual, two serum samples, one at HAART initiation and another 24 months later, were tested for latent and lytic KSHV antibodies using immunofluorescence assays, and for KSHV viremia using PCR. Factors associated with changes in KSHV antibody titers and viremia were evaluated. Results: At HAART initiation, 69.1 and 75.0% of patients were seropositive to latent and lytic KSHV antibodies, respectively. Seropositivity was associated with the presence of Kaposi sarcoma, older age, lower CD8(+) cell count and higher CD4(+)/CD8(+) ratio. Prevalence of KSHV viremia at HAART initiation was 6.4%, being significantly higher among patients with Kaposi sarcoma (35.0%), and those with HIV viral loads 100 000 copies/ml (11.7%) or higher. At 24-month follow-up, geometric mean titers (GMTs) among KSHV seropositive patients increased and antibody seroprevalence was higher. Having Kaposi sarcoma and/or CD4(+) cell counts less than 50 cells/mu l at HAART initiation was associated both with higher probability for antibody titers to increase (including seroconversion) and larger increases in GMTs. Only one of 17 viremic patients at HAART initiation had viremia at 24-month follow-up. Conclusion: HAART increases KSHV-specific humoral immune response and clearance of viremia among HIV-infected MSM, consistent with the dramatic protection offered by HAART against Kaposi sarcoma. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins
引用
收藏
页码:2245 / 2252
页数:8
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