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

Marina Giuliano, Maria Franca Pirillo, Giuseppe Liotta, Mauro Andreotti, Haswell Jere, Jean Baptiste Sagno, Fausto Ciccacci, Roberta Amici, Maria Cristina Marazzi, Stefano Vella, Leonardo Palombi, Sandro Mancinelli

Research output: Contribution to journalArticle

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/mm3 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.

Original languageEnglish
Pages (from-to)17-19
Number of pages3
JournalJournal of Clinical Virology
Volume96
DOIs
Publication statusPublished - Nov 1 2017

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Cytomegalovirus
Immunoglobulin G
HIV
CD4 Lymphocyte Count
Antibodies
Cytomegalovirus Infections
Viral Load
Pregnant Women
Therapeutics
Asymptomatic Infections
Time and Motion Studies
Africa South of the Sahara
Postpartum Period
Guidelines
Lymphocytes
Pregnancy
Infection
Population

Keywords

  • Antiretroviral therapy
  • CMV infection
  • HIV infection
  • Humoral immune response
  • Pregnancy

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

Cite this

High CMV IgG antibody levels are associated to a lower CD4+ RESPONSE to antiretroviral therapy in HIV-infected women. / Giuliano, Marina; Pirillo, Maria Franca; Liotta, Giuseppe; Andreotti, Mauro; Jere, Haswell; Sagno, Jean Baptiste; Ciccacci, Fausto; Amici, Roberta; Marazzi, Maria Cristina; Vella, Stefano; Palombi, Leonardo; Mancinelli, Sandro.

In: Journal of Clinical Virology, Vol. 96, 01.11.2017, p. 17-19.

Research output: Contribution to journalArticle

Giuliano, Marina ; Pirillo, Maria Franca ; Liotta, Giuseppe ; Andreotti, Mauro ; Jere, Haswell ; Sagno, Jean Baptiste ; Ciccacci, Fausto ; Amici, Roberta ; Marazzi, Maria Cristina ; Vella, Stefano ; Palombi, Leonardo ; Mancinelli, Sandro. / High CMV IgG antibody levels are associated to a lower CD4+ RESPONSE to antiretroviral therapy in HIV-infected women. In: Journal of Clinical Virology. 2017 ; Vol. 96. pp. 17-19.
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T1 - High CMV IgG antibody levels are associated to a lower CD4+ RESPONSE to antiretroviral therapy in HIV-infected women

AU - Giuliano, Marina

AU - Pirillo, Maria Franca

AU - Liotta, Giuseppe

AU - Andreotti, Mauro

AU - Jere, Haswell

AU - Sagno, Jean Baptiste

AU - Ciccacci, Fausto

AU - Amici, Roberta

AU - Marazzi, Maria Cristina

AU - Vella, Stefano

AU - Palombi, Leonardo

AU - Mancinelli, Sandro

PY - 2017/11/1

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N2 - 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/mm3 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.

AB - 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/mm3 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.

KW - Antiretroviral therapy

KW - CMV infection

KW - HIV infection

KW - Humoral immune response

KW - Pregnancy

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