Risk factors in HIV-1-infected patients developing repetitive bacterial infections: toxicological, clinical, specific antibody class responses, opsonophagocytosis and Fcγ RIIa polymorphism characteristics
A. PAYERAS,
P. MARTINEZ, J. MILà, M. RIERA,
A. PAREJA,
J. CASAL,
N. MATAMOROS,
A. PAYERAS
Infectious Diseases Units, Hospital Son Dureta and Fundació Hospital Son Llatzer,
Search for more papers by this authorM. RIERA
Infectious Diseases Units, Hospital Son Dureta and Fundació Hospital Son Llatzer,
Search for more papers by this authorA. PAREJA
Infectious Diseases Units, Hospital Son Dureta and Fundació Hospital Son Llatzer,
Search for more papers by this authorJ. CASAL
Laboratorio de Referencia de Neumococos, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Spain
Search for more papers by this authorA. PAYERAS,
P. MARTINEZ, J. MILà, M. RIERA,
A. PAREJA,
J. CASAL,
N. MATAMOROS,
A. PAYERAS
Infectious Diseases Units, Hospital Son Dureta and Fundació Hospital Son Llatzer,
Search for more papers by this authorM. RIERA
Infectious Diseases Units, Hospital Son Dureta and Fundació Hospital Son Llatzer,
Search for more papers by this authorA. PAREJA
Infectious Diseases Units, Hospital Son Dureta and Fundació Hospital Son Llatzer,
Search for more papers by this authorJ. CASAL
Laboratorio de Referencia de Neumococos, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Spain
Search for more papers by this author Antoni Payeras, Infectious Diseases Unit, Fundació Hospital Son Llatzer, C. Manacor Km 4, 07198 Palma de Mallorca, Balears, Spain. E-mail: [email protected]
Abstract
Summary The aim of the study was to determine possible factors related to the risk of developing recurrent bacterial respiratory tract infections in HIV-1-infected patients, regardless of the degree of immune cellular impairment. Thirty-three HIV-1 seropositive patients with previous repetitive bacterial respiratory tract infections (case group), 33 HIV-1 seropositive controls (matched by CD4-cell counts) without these antecedents and 27 healthy controls were studied before and after administration of pneumococcal and Haemophilus influenzae type b vaccines. Clinical or toxicological variables, cutaneous tests, complement factors, beta2-microglobulin, serum IgM, IgA, IgG and subclasses, specific antibodies (IgG, IgG2, IgA) against pneumococcal vaccine and polyribosylribitol phosphate (PRP), their avidity, opsonophagocytosis and IgG2m and FcγRIIa allotypes were determined. A history of drug abuse (P = 0·001), less likelihood of receiving high activity antiretroviral treatment high activity antiretroviral treatment (HAART) (P = 0·01), higher levels of HIV-1 viral load (P < 0·05), serum IgG (P < 0·01) and beta2-microglobulin (P < 0·01) were observed in the case group. Also, a lower increase in specific antibodies to pneumococcal vaccine and PRP was demonstrated in the cases in comparison with the two control groups. No differences were observed in the avidity of antibodies, opsonophagocytic capacity or IgG2m and FcγRIIa allotypes between the three groups. These data indicate that vaccination strategies against encapsulated bacteria can be unsuccessful in the HIV-1-infected patients presenting repetitive bacterial respiratory tract infections if behavioural aspects or measures to improve adherence to HAART therapies are not considered.
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