HIV-1 Infection and the Aging of the Immune System: Facts, Similarities and Perspectives

Biasi, Sara De; Nasi, Milena; Gibellini, Lara; Bertoncelli, Linda; Manzini, S; Mussini, Cristina; Cossarizza, Andrea

doi:10.1016/j.jecm.2011.06.001

Cited by 17 publications

(11 citation statements)

References 105 publications

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“…The persistent immune activation present in HIV infection leads to a subsequent exhaustion of the T cell compartment. Thus, several abnormalities are similar to what happens during ageing [19], among which the shrinkage of the T cell repertoire [20], the accumulation of oligoclonal expansions of memory/effector cells directed toward infectious agents, the involution of the thymus [21] and the exhaustion of naive T cells [22].…”

Section: Immunosenescence and Chronic Inflammationmentioning

confidence: 91%

Ageing and inflammation in patients with HIV infection

Nasi

Biasi

Gibellini

et al. 2016

Clinical and Experimental Immunology

223

155

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Summary Nowadays, HIV1 patients have an expected lifespan that is only slightly shorter than healthy individuals. For this reason, along with the fact that infection can be acquired at a relatively advanced age, the effects of ageing on HIV 1 people have begun to be evident. Successful anti-viral treatment is, on one hand, responsible for the development of side effects related to drug toxicity; on the other hand, it is not able to inhibit the onset of several complications caused by persistent immune activation and chronic inflammation. Therefore, patients with a relatively advanced age, i.e. aged more than 50 years, can experience pathologies that affect much older citizens. HIV 1 individuals with non-AIDS-related complications can thus come to the attention of clinicians because of the presence of neurocognitive disorders, cardiovascular diseases, metabolic syndrome, bone abnormalities and non-HIV-associated cancers. Chronic inflammation and immune activation, observed typically in elderly people and defined as 'inflammaging', can be present in HIV 1 patients who experience a type of premature ageing, which affects the quality of life significantly. This relatively new condition is extremely complex, and important factors have been identified as well as the traditional behavioural risk factors, e.g. the toxicity of anti-retroviral treatments and the above-mentioned chronic inflammation leading to a functional decline and a vulnerability to injury or pathologies. Here, we discuss the role of inflammation and immune activation on the most important non-AIDS-related complications of chronic HIV infection, and the contribution of aging per se to this scenario.

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Section: Immunosenescence and Chronic Inflammationmentioning

confidence: 91%

Ageing and inflammation in patients with HIV infection

Nasi

Biasi

Gibellini

et al. 2016

Clinical and Experimental Immunology

223

155

View full text Add to dashboard Cite

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“…Advanced age is a significant risk factor for pneumococcal disease in HIV+ and HIV− individuals [3,11]. Both aging and HIV infection contribute to B cell dysfunction, resulting in decreased responses to vaccination [9–12]. …”

Section: Introductionmentioning

confidence: 99%

Quantitative and Functional Antibody Responses to the 13-Valent Conjugate and/or 23-Valent Purified Polysaccharide Vaccine in Aging HIV-Infected Adults

et al. 2016

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Background The number of aging human immunodeficiency virus-infected (HIV+) individuals living in the United States has substantially grown over the past two decades. Advanced age and HIV infection both increase susceptibility to Streptococcus pneumoniae infection due to B cell dysfunction. The combined impact of these factors on pneumococcal vaccine responses remains unknown. Methods We assessed serum immunoglobulin (Ig) G and IgM levels and opsonophagocytic killing assay (OPA) titers to pneumococcal serotypes 14 and 23F in HIV+ subjects and HIV-uninfected (HIV−) controls 50–65 years old. HIV+ individuals with CD4+ T cells/μl (CD4) >200 and ≥1 year of antiretroviral therapy (ART) received either a dose of the 13-valent pneumococcal conjugate vaccine followed by the 23-valent pneumococcal polysaccharide vaccine 8 weeks later (PCV/PPV) as currently recommended (n=15) or a single dose of PPV only (n=22). HIV− controls received PCV/PPV (n=14). Results HIV+ PCV/PPV and PPV groups exhibited similar increases in IgG levels and OPA titers for both serotypes after immunization. Postvaccination IgM levels for serotype 23F, but not 14, were significantly higher in HIV+ PCV/PPV compared to PPV groups. IgG and IgM levels for serotype 14 and OPA titers to serotype 23F were significantly reduced in HIV+ compared to HIV− PCV/PPV groups. Serotype-specific IgG levels correlated with OPA titers for all groups. Conclusions Our data suggest that the recommended PCV/PPV regimen may not significantly improve quantitative or functional antibody responses compared to PPV only in aging HIV+ subjects. Continued efforts aimed at improving vaccine responses in this high risk population are warranted.

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“…In addition, HIV infection causes B cell polyclonal activation, hypergammaglobulinemia, and high spontaneous antibody production in vitro during early stages of disease before quantitative and qualitative defects in CD4+T cells occur, suggesting intrinsic B cell defects [ 14 – 18 ]. This results in the production of excessive but non-functional antibodies [ 19 ]. Conversely, functional anti-pneumococcal IgM and IgG antibodies critical for bacterial clearance are severely reduced in HIV-positive individuals immunized with PPV23 compared to HIV-negative individuals [ 20 – 22 ].…”

Section: Introductionmentioning

confidence: 99%

Response to Pneumococcal Polysaccharide Vaccination in Newly Diagnosed HIV-Positive Individuals

et al. 2015

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BackgroundNewly diagnosed HIV-positive individuals are 35 to 100-fold more susceptible to Streptococcus pneumoniae infection compared to non-infected individuals. Therefore, the 23-valent pneumococcal polysaccharide vaccine (PPV23) has previously been recommended, though efficacy and effectiveness of vaccination remains controversial. Early severe B cell dysfunction is a central feature of HIV infection. The specific nature of the immune cells involved in the production of protective antigen-specific antibodies in HIV-positive individuals remains to be elucidated.ObjectivesEvaluate the antibody and antigen-specific B cell response to the 23-valent pneumococcal polysaccharide vaccine in newly diagnosed HIV-positive patients. Moreover, determine if newly diagnosed patients with CD4<200 cells/μl benefit from 6–12 months of HAART, allowing partial viral suppression and immune reconstitution, prior to immunization.MethodsNewly diagnosed HIV-positive patients with CD4>200 cells/μl and CD4<200 cells/μl were immunized with PPV23. Patients with CD4<200 cells/μl received either immediate or delayed immunization following 6–12 months of HAART. Antibody responses, opsonophagocytic activity and phenotypic analysis of pneumococcal polysaccharide-specific B cells were studied.ResultsNewly diagnosed HIV-positive patients demonstrated CD4-dependent increases in antibody and opsonophagocytic titers thought to be commensurate with protection. Functional opsonophagocytic titers of patients with CD4<200 cells/μl immunized immediately compared to patients with CD4<200 cells/μl receiving HAART for 6–12 months were not significantly different. Pneumococcal polysaccharide-specific B cells were distributed evenly between IgM memory and switched memory B cells for all groups, but IgM memory B cells were significantly lower than in HIV-negative individuals.ConclusionsDespite CD4-dependent pneumococcal polysaccharide-specific deficiencies in newly diagnosed HIV-positive patients, vaccination was beneficial based on opsonophagocytic titers for all newly diagnosed HIV-positive groups. In HIV-positive patients with CD4<200 cells/μl, 6–12 months of HAART did not improve opsonophagocytic titers or antibody concentrations. Based on these findings, immunization with the 23-valent pneumococcal polysaccharide vaccine should not be delayed in newly diagnosed HIV-positive patients with CD4<200 cells/μl.

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HIV-1 Infection and the Aging of the Immune System: Facts, Similarities and Perspectives

Cited by 17 publications

References 105 publications

Ageing and inflammation in patients with HIV infection

Ageing and inflammation in patients with HIV infection

Quantitative and Functional Antibody Responses to the 13-Valent Conjugate and/or 23-Valent Purified Polysaccharide Vaccine in Aging HIV-Infected Adults

Response to Pneumococcal Polysaccharide Vaccination in Newly Diagnosed HIV-Positive Individuals

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