The controversial impact of B cells subsets on immune response to pneumococcal vaccine in HIV-1 patients

Int J Infect Dis. 2015 Sep:38:24-31. doi: 10.1016/j.ijid.2015.07.008. Epub 2015 Jul 17.

Abstract

Background: Chronic HIV infection leads to severe perturbations of the B cell populations and hypo-responsiveness to vaccines. The associations between circulating B cell subpopulations and the antibody response to pneumococcal polysaccharide vaccine in antiretroviral-naïve and treated patients were studied.

Methods: Sixty-six HIV-infected adults were grouped according to antiretroviral therapy (ART) and CD4+ cell count; 31 were ART-naïve and 35 were ART-treated, and they were matched for age, CD4 cell count, and duration of HIV infection. All subjects were immunized with the 23-valent polysaccharide vaccine against Streptococcus pneumoniae. Pre- and post-vaccination B cell subpopulations were assessed by flow cytometry. Serum IgG concentrations for vaccine serotypes were quantified by ELISA at baseline and at 4 and 48 weeks post-vaccination.

Results: Patients under highly active antiretroviral therapy (HAART) had significantly higher antibody levels against pneumococcal vaccine antigens, while an adequate number of patients responded to vaccination. Memory B cells were diminished over time, although treated patients maintained higher levels of all subsets studied, with the exception of activated memory and isotype-switched memory B cells.

Conclusions: Low concentrations of total B cells and exhausted memory B cells was the strongest independent predictor of poor pneumococcal vaccine responsiveness, emphasizing that B cell subset disturbances are associated with a poor vaccine response among HIV-infected patients.

Keywords: Antibody response; B cell subsets; HIV-1 infection; Memory cells; Phagocytosis.

MeSH terms

  • Adult
  • Antibodies, Bacterial / blood
  • Antiretroviral Therapy, Highly Active
  • B-Lymphocyte Subsets / immunology*
  • CD4 Lymphocyte Count
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / immunology*
  • HIV-1*
  • Humans
  • Immunologic Memory
  • Longitudinal Studies
  • Male
  • Pneumococcal Vaccines / immunology*
  • Streptococcus pneumoniae / immunology
  • Young Adult

Substances

  • 23-valent pneumococcal capsular polysaccharide vaccine
  • Antibodies, Bacterial
  • Pneumococcal Vaccines