NEW YORK (Reuters Health) - The findings from a small preliminary clinical trial suggest that an inactivated virus-pulsed dendritic-cell vaccine is a useful treatment for chronic HIV-1 infection. If confirmed in further studies, treatment with this vaccine may allow patients to “live without harmful and expensive daily antiretroviral drugs.”
The new findings compliment those of an earlier report by the same research group showing that a dendritic-cell vaccine produces a strong anti-SIV response in rhesus monkeys (see Reuters Health report December 23, 2002).
As reported in the November 28th online issue of Nature Medicine, Dr. Wei Lu, from the from the Universite Paris, and colleagues treated 18 chronically HIV-infected patients with the dendritic-cell vaccine, which is pulsed with a whole virus. None of the subjects were receiving other therapies at the time and had stable viral loads for at least 6 months.
In the first 112 days after immunization, plasma viral levels fell by a median of 80%, the researchers note. In eight subjects, viral loads were suppressed by more than 90% for at least 1 year.
The amount of suppression achieved was directly related to the number of interferon-gamma-expressing CD4+ T cells and HIV-1 gag-specific perforin-expressing CD8+ effector cells as well as the amount of HIV-1-specific interleukin-2. These correlations suggest that a robust virus-specific CD4+ T-helper type 1 response is critical for containing HIV in vivo, the researchers note.
“This is the first demonstration in humans that a therapeutic vaccine made of autologous monocyte-derived dendritic cells pulsed with autologous inactivated whole HIV-1 is capable of inducing an effective HIV-1-specific T-cell response associated with sustained viral suppression,” the authors state.
Still, they caution that the “efficacy of such a therapeutic vaccine will not be definitively proven until a randomized trial with an appropriate control arm has been performed.”
Source: Nat Med 2004. [ Google search on this article ]
MeSH Headings: Clinical Trials : Environment and Public Health : Epidemiologic Methods : Evaluation Studies : Health : Health Occupations : Health Services Administration : Medicine : Investigative Techniques : Population Characteristics : Preventive Medicine : Public Health : Quality of Health Care : Specialties, Medical : Viral Vaccines : Epidemiologic Study Characteristics : AIDS Vaccines : Health Care Quality, Access, and Evaluation : Health Care Evaluation Mechanisms : Analytical, Diagnostic and Therapeutic Techniques and Equipment : Biological Sciences : Health Care
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