Immunologic parameters in early-stage HIV-seropositive subjects associated with vaccine responsiveness

Twenty-one asymptomatic HIV-seropositive subjects and 20 HIV-seronegative controls were assessed for their serologic response to multiple live attenuated viral, protein (toxoid), and polysaccharide vaccine antigens. Extensive in vivo and in vitro immunologic evaluations were performed. Factors predictive of immunogen responsiveness by HIV-seropositive patients were found by correlating vaccine responses with results of T- and B-cell functional assays. Eleven HIV-seropositive patients (HIV nonresponsive-NR) responded to only one of three vaccines used for analysis (meningococcus, group C; adenovirus 4, 7; and diphtheria-tetanus) compared with the normals, of whom 100% responded to two or more of the same immunogens. Ten HIV-seropositive patients (HIV responsive-R) responded equivalently to normals. The HIV NR group had distinctive immunologic abnormalities predictive of their poor immunogen responsiveness. These included defects in the T-cell helper function despite normalization of T cell number and defective T-cell suppression of Epstein-Barr virus (EBV) in vitro (HIV NR, 30% suppression; HIV R, 73% suppression; and normals, 95% suppression of EBV-driven immunoglobulin production in vitro). The B cells of the HIV NR groups were also abnormal in vivo. The HIV NR patients' B cells were larger and had increased native response to B-cell growth factor evidenced by increased thymidine incorporation. (HIV-NR, 10,232 +/- 3,003 cpm; HIV R, 5,432 +/- 1,125; normal, 402 +/- 11. HIV NR/HIV R, p less than 0.05; HIV NR/N, p less than 0.001.)(ABSTRACT TRUNCATED AT 250 WORDS)