Increase in plasma viral load after oral cholera immunization of HIV-infected subjects
Ortigão-de-Sampaio, M.B.; Shattock, R.J.; Hayes, P.; Griffin, G.E.; Linhares-de-Carvalho, M.I.; Ponce de Leon, A.; Lewis, D.J.; Castello-Branco, L.R.
Aids 12(14): F145-F150
1998
ISSN/ISBN: 0269-9370 PMID: 9792370 DOI: 10.1097/00002030-199814000-00001Document Number: 533794
Objective: Constant antigenic stimulation of the large immune cell population contained within gut-associated lymphoid tissue during HIV infection may contribute to patients' total viral load. The aim of this investigation was to evaluate the effect of a mucosal antigenic challenge on HIV replication. Design: Prospective clinical study. Methods: Twelve HIV-1-infected men (mean age, 42.3 years) from the Casa de Apoio Santo Antonio, Rio de Janeiro, Brazil, were immunized with combined whole cell-toxin B subunit oral cholera vaccine. Blood was collected on days 0, 2, 4, 6, 10 and 15 after immunization and plasma was tested for cholera toxin-specific antibody response (IgG and IgA), beta2-Microglobulin, and plasma viral load. CD4 lymphocyte counts were performed within 1 week before immunization. Five HIV-infected nonimmunized individuals were studied as controls. Results: There were no adverse effects following immunization and no deterioration in clinical outcome during 3 months of follow-up. A transient increase in viral load that ranged from twofold to 60-fold was observed in all cases and was statistically significant on days 2, 6 and 10 (P = 0.01 7, P = 0.025, P = 0.021, respectively). There was no correlation with CD4 cell counts. None of the non-immunized subjects demonstrated the pattern of viraemia observed after immunization (P > 0.10 on all days). Conclusions: Our data indicate that mucosal immunization with oral cholera vaccine induces a transient increase in HIV viraemia, regardless of clinical stage of infection and CD4 cell counts. These findings suggest that mucosal stimulation of HIV-infected patients enhances HIV replication.