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Inflammatory markers predict vaccine response in HCV, HIV

 

Key clinical point: Prevaccination inflammatory markers in patients with chronic HCV, HIV may predict response to HAV, HBV, and tetanus vaccines.

Major finding: HCV/HIV-associated inflammatory markers reflect immune dysfunction and poor performance of subsequent vaccinations.

Study details: Clinical trials comparing 15 HCV-infected, 24 HIV-infected, and 10 uninfected control patients.

Disclosures: The authors reported having no conflicts. The study was funded by U.S. government grants.

Source: Shive, CL et al. Vaccine 2018;38:453-60.


 

FROM VACCINE

In patients with chronic hepatitis C (HCV) and HIV infection, blood protein markers showing evidence of systemic inflammation were associated with a poor immune response to hepatitis A/hepatitis B vaccination, according to a study of blood samples obtained in two small clinical trials.

Prevaccination plasma levels of inflammatory proteins IP10, IL-6, and sCD14 were elevated in both HCV- and HIV-infected patients, while sCD163 was also elevated in HCV-infected patients, according to the report in Vaccine.

Fifteen HCV-infected, 24 HIV-infected, and 10 uninfected control patients followed an appropriate vaccination course for a combined hepatitis A–hepatitis B vaccine. Antibody levels against the challenging vaccine proteins were assessed and quantified by ELISA, according to Carey L. Shive, PhD, of Louis Stokes Cleveland VA Medical Center, and her colleagues.

After HAV/HBV vaccination, HCV- and HIV-infected patients had lower and less durable HAV and HBV antibody responses than those of uninfected control patients. This was inversely correlated with the level of the inflammatory proteins seen in HCV-infected patients. The level of the HAV/HBV antibody response was too low in the HIV-infected patients to assess correlations with the inflammatory protein levels.

The researchers speculated that the elevated blood inflammatory markers indicated similar elevation in lymph node tissues, where high levels of the proteins may effect the survival and function of T follicular helper cells that may influence the generation of B cell antibody response and B cell memory activation to vaccination.

“Understanding mechanisms underlying immune impairment during chronic viral infection is needed to guide strategies to improve immune health during these morbid infections,” the researchers concluded.

The authors reported having no conflicts. The study was funded by U.S. government grants.

Source: Shive, CL et al. Vaccine 2018;38:453-60.

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