Background: Virtually all HIV-infected women in sub-Saharan Africa have evidence of Cytomegalovirus (CMV) infection and levels of specific anti-CMV IgG have been suggested to represent more intense reactivation of subclinical infection. Studies have also shown direct influence of CMV on lymphocytes.Objective: The aim of this study was to determine if levels of anti-CMV specific antibodies could impact on the immunological response to antiretroviral treatment (ART) in HIV-infected pregnant women.Study design: CMV-specific IgG were measured in HIV-infected pregnant women at 26 weeks of gestation (before ART initiation). Women received ART until 6 months postpartum or indefinitely according to local guidelines at the time of the study. Immunological and virological responses were assessed 6 months and 24 months after delivery.Results: A total of 81 women were studied. At baseline high levels (above the median) of specific IgG were associated to a low CD4+ cell count (P<0.001), a high viral load (P=0.003), and to an older age (P=0.051). In a multivariate model adjusting for baseline CD4+ count, baseline viral load and age, the presence of low levels of CMV IgG was the only independent predictor of a a CD4+ count above 500/mm(3) 24 months after delivery among women on continuous therapy.Conclusions: In this cohort, levels of CVM IgG had a significant influence on the immunological response to ART, adding information to the known impact of CMV infection in the HIV-positive population, and underlining the need of new strategies to contain the infection.

Giuliano, M., Pirillo, M.f., Liotta, G., Andreotti, M., Jere, H., Sagno, J.-., et al. (2017). High CMV IgG antibody levels are associated to a lower CD4+ RESPONSE to antiretroviral therapy in HIV-infected women. JOURNAL OF CLINICAL VIROLOGY, 96, 17-19 [10.1016/j.jcv.2017.08.016].

High CMV IgG antibody levels are associated to a lower CD4+ RESPONSE to antiretroviral therapy in HIV-infected women

Liotta G.;Palombi L.;Mancinelli S.
2017

Abstract

Background: Virtually all HIV-infected women in sub-Saharan Africa have evidence of Cytomegalovirus (CMV) infection and levels of specific anti-CMV IgG have been suggested to represent more intense reactivation of subclinical infection. Studies have also shown direct influence of CMV on lymphocytes.Objective: The aim of this study was to determine if levels of anti-CMV specific antibodies could impact on the immunological response to antiretroviral treatment (ART) in HIV-infected pregnant women.Study design: CMV-specific IgG were measured in HIV-infected pregnant women at 26 weeks of gestation (before ART initiation). Women received ART until 6 months postpartum or indefinitely according to local guidelines at the time of the study. Immunological and virological responses were assessed 6 months and 24 months after delivery.Results: A total of 81 women were studied. At baseline high levels (above the median) of specific IgG were associated to a low CD4+ cell count (P<0.001), a high viral load (P=0.003), and to an older age (P=0.051). In a multivariate model adjusting for baseline CD4+ count, baseline viral load and age, the presence of low levels of CMV IgG was the only independent predictor of a a CD4+ count above 500/mm(3) 24 months after delivery among women on continuous therapy.Conclusions: In this cohort, levels of CVM IgG had a significant influence on the immunological response to ART, adding information to the known impact of CMV infection in the HIV-positive population, and underlining the need of new strategies to contain the infection.
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/42 - Igiene Generale e Applicata
Settore MED/17 - Malattie Infettive
Settore MED/09 - Medicina Interna
English
Con Impact Factor ISI
Antiretroviral therapy; CMV infection; HIV infection; Humoral immune response; Pregnancy; Adult; Africa South of the Sahara; Anti-Retroviral Agents; Antibodies, Viral; CD4 Lymphocyte Count; CD4-Positive T-Lymphocytes; Coinfection; Cytomegalovirus Infections; Female; HIV Infections; Humans; Immunity, Cellular; Immunity, Humoral; Immunoglobulin G; Pregnancy; Pregnancy Complications, Infectious; Viral Load; Young Adult
https://www.sciencedirect.com/science/article/pii/S1386653217302469?via%3Dihub
Giuliano, M., Pirillo, M.f., Liotta, G., Andreotti, M., Jere, H., Sagno, J.-., et al. (2017). High CMV IgG antibody levels are associated to a lower CD4+ RESPONSE to antiretroviral therapy in HIV-infected women. JOURNAL OF CLINICAL VIROLOGY, 96, 17-19 [10.1016/j.jcv.2017.08.016].
Giuliano, M; Pirillo, Mf; Liotta, G; Andreotti, M; Jere, H; Sagno, J-; Ciccacci, F; Amici, R; Marazzi, Mc; Vella, S; Palombi, L; Mancinelli, S
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/211407
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