Immunity in HIV-1-Infected Adults with a Previous State of Moderate-Severe Immune-Suppression and More Than 500 CD4+ T Cell After Highly Active Antiretroviral Therapy

Resino, Salvador; Rivero, L.; Ruiz‐Mateos, Ezequiel; Galán, Isabel; Franco, Jaime M.; Muñoz‐Fernández, María Ángeles; Leal, Manuel

doi:10.1023/b:joci.0000029112.82425.59

Cited by 16 publications

(9 citation statements)

References 42 publications

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Section: Discussionmentioning

confidence: 99%

“…This finding is in line with previous observations that severely immunosuppressed HIV-infected patients with very low CD4+ T-cell counts at baseline have less complete immune reconstitution after initiation of HAART, despite improvement of CD4+ T-cell counts and suppression of HIV replication below detection levels. 20,21 One explanation might be the persistence of low levels of viral replication with chronic antigen stimulation and T-cell activation, thus preventing a complete immune restoration during HAART.HPV 26 was also identified in swabs from perianal leucoplakias, which histologically were confirmed as multifocal HSIL. Although we cannot formally exclude an adjunct causal role of HPV 26 coinfection, perianal swab samples were also positive by hc2 test for high-risk (and low-risk) mucosal HPV types, the presence of which suffices to explain the development of perianal intraepithelial neoplasia.…”

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confidence: 99%

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Human papillomavirus type 26 infection causing multiple invasive squamous cell carcinomas of the fingernails in an AIDS patient under highly active antiretroviral therapy

Handisurya

Rieger

Bankier³

et al. 2007

Br J Dermatol

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SummarySquamous cell carcinoma (SCC) of the nail unit is a rare disorder. An association with high-risk genital human papillomavirus (HPV) infection has been reported. We report a 28-year-old human immunodeficiency virus (HIV)-infected bisexual man who had multiple invasive SCC of the fingers, infected with the rare type HPV 26. Classification of HPV 26 as high-or intermediate-risk type has been uncertain, due to its rare presence in cervical cancer. Despite successful treatment with highly active antiretroviral therapy (HAART), the patient developed extensive hyperkeratotic nailbed proliferations of all fingers. Tumours were refractory to treatment and invaded into adjacent tissues. X-rays of the hands demonstrated bone invasion, necessitating amputation of distal phalanges of several fingers. Histologically, highly differentiated preinvasive and invasive verrucous SCCs were identified. Molecular DNA typing identified HPV 26 in the SCCs and in some premalignant lesions. By in situ hybridization HPV 26 DNA was detected in numerous tumour cells, indicating productive infection with high-level amplification of the viral genome. In the remaining proliferations, high-risk HPV type 58, cutaneous HPVs and a putative new HPV type were identified. HPV 26 infection appears to be causally involved in the development of SCC of the nail unit in this immunosuppressed patient. Timely evaluation of chronic verrucous nailbed tumours is recommended, especially in immunocompromised patients. Identification of HPV 26, besides known high-risk HPV types, may identify patients at risk for developing SCC of the nailbed and possibly at other locations. especially on sun-exposed areas, whereas a possible role of HPV in keratinocyte (nonmelanoma) skin cancer of immunocompetent and immunosuppressed individuals is less clear. [4][5][6] SCC originating from the nail unit is rare, and misdiagnosis as onychomycosis or verruca vulgaris is quite common. SCC of the finger usually affects older age groups, and men more often than women. 7,8 An association with preceding radiation, chronic trauma or infection, immunosuppression, and exposure to hydrocarbons or arsenic has been reported. 8,9 Infection with high-risk HPV has been causally implicated in the pathogenesis of digital SCC, and the predominant type identified was HPV 16, suggesting that its high oncogenicity largely accounts for it being the main HPV type identified in most cases (similar to cervical cancer). KeywordsTo a lesser extent HPV 31, 33 (our unpublished observation), 34 and 35 have been identified, all closely related phylogenetically to HPV 16, as all are species 9 alphapapillomavirus 1,7 or species 11 alpha-papillomavirus. 10 Digital SCCs have been reported in patients with concomitant or antecedent genital HPV infection, and a proportion associated with cervical cancer, but most with genital warts or cervical dysplasia. The presence of the same HPV type in the digital and genital lesions has been identified. 8 Case reportA 28-year-old human immunodeficiency virus (HIV)-infect...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Human papillomavirus type 26 infection causing multiple invasive squamous cell carcinomas of the fingernails in an AIDS patient under highly active antiretroviral therapy

Handisurya

Rieger

Bankier³

et al. 2007

Br J Dermatol

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“…5,6,11 Functional immune reconstitution with HAART can be incomplete in those with preceding severe immunodeficiency. [32][33][34][35][36][37][38] Whereas small studies in children demonstrated improved responses to vaccinations after HAART, a study of previously severely immunosuppressed HIV-infected adults treated with HAART found impaired responses to vaccinations. [39][40][41] The similarity of the response to pneumococcal vaccination in our population to that of HIV-uninfected children is consistent with functional immune reconstitution, although the strength of this conclusion is limited by its reliance on a quantitative rather than functional assessment.…”

Section: Discussionmentioning

confidence: 99%

Immunogenicity, Safety, and Predictors of Response After a Pneumococcal Conjugate and Pneumococcal Polysaccharide Vaccine Series in Human Immunodeficiency Virus-Infected Children Receiving Highly Active Antiretroviral Therapy

Abzug¹,

Pelton²,

Song³

et al. 2006

The Pediatric Infectious Disease Journal

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“…IL‐5 responses to mitogen were elevated in HIV‐1 patients with > 500 CD4 T cells/µl and undetectable plasma HIV RNA on ART. The increase was greatest in patients with a nadir of < 300 CD4 T cells/µl 24 . The numbers of CD4 T cells producing IL‐5 after stimulation with staphylococcal enterotoxin B and anti‐CD28 were also elevated in untreated patients with > 200 CD4 T cells/µl 25 .…”

Section: Introductionmentioning

confidence: 99%

A T2 cytokine environment may not limit T1 responses in human immunodeficiency virus patients with a favourable response to antiretroviral therapy

et al. 2006

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Summary Low‐level production of interferon‐γ (IFN‐γ) marks human immunodeficiency virus (HIV)‐induced immunodeficiency and has been ascribed to a bias towards T2 cytokines. This was investigated in two cross‐sectional studies of HIV patients who were immunodeficient when they began antiretroviral therapy (ART) and had stable increases in CD4 T‐cell counts. Blood leucocytes were assessed unstimulated or after stimulation with cytomegalovirus (CMV), anti‐CD3 or mitogen. IFN‐γ and interleukin (IL)‐5 responses were initially assessed by enzyme‐linked immunosorbent spot‐forming cell assay (ELISPOT) and enzyme‐linked immunosorbent assay (ELISA). We then adopted a sensitive reverse transcription–polymerase chain reaction (RT–PCR) system to assess IFN‐γ, IL‐5, IL‐4 and IL‐4δ2 (an inhibitory splice variant of IL‐4) mRNA. The results were correlated with putative serological markers of a T1 [lymphocyte activation gene‐3 (LAG‐3), CD26] or a T2 [CD30, immunoglobulin E (IgE)] cytokine environment. IL‐5 production and IgE levels were elevated in patients. IgE levels did not correlate with IFN‐γ, but showed an inverse correlation with IL‐5 released in culture (P = 0·05). The levels of IL‐4, IFN‐γ, IL‐5 and IL‐4δ2 mRNA were correlated after anti‐CD3 stimulation, where IL‐5 was the best predictor of IFN‐γ mRNA (P = 0·006). Weak positive correlations were evident between CD30 and cytokine mRNA levels, whilst IgE correlated inversely with IL‐4, IL‐4δ2, IL‐5 and IFN‐γ mRNA levels. These analyses provide no evidence for an inverse relationship between T1 and T2 cytokine responses in HIV patients, but suggest that the elevation of IgE marks low cytokine responses.

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Immunity in HIV-1-Infected Adults with a Previous State of Moderate-Severe Immune-Suppression and More Than 500 CD4+ T Cell After Highly Active Antiretroviral Therapy

Cited by 16 publications

References 42 publications

Human papillomavirus type 26 infection causing multiple invasive squamous cell carcinomas of the fingernails in an AIDS patient under highly active antiretroviral therapy

Human papillomavirus type 26 infection causing multiple invasive squamous cell carcinomas of the fingernails in an AIDS patient under highly active antiretroviral therapy

Immunogenicity, Safety, and Predictors of Response After a Pneumococcal Conjugate and Pneumococcal Polysaccharide Vaccine Series in Human Immunodeficiency Virus-Infected Children Receiving Highly Active Antiretroviral Therapy

A T2 cytokine environment may not limit T1 responses in human immunodeficiency virus patients with a favourable response to antiretroviral therapy

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