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: Human immunodeficiency virus (HIV)-infected persons manifest decreased antibody responses to pneumococcal polysaccharide vaccines. Since human antibody responses to polysaccharides are often restricted, the molecular structure of antibodies elicited by a 23-valent pneumococcal vaccine was analyzed. Anti-idiotypic reagents were used to detect VH1, VH3, and VH4 gene usage by antibodies to pneumococcal capsular polysaccharides in HIV-uninfected and HIV-infected subjects by ELISA. HIV-uninfected persons generated [beta]-mercaptoethanol-sensitive and -resistant antibodies to pneumococcal capsular polysaccharides expressing VH3 determinants recognized by the D12, 16.84, and B6 monoclonal antibodies; antibodies expressing VH1 determinants were not detected, and VH4 determinants were expressed by [beta]-mercaptoethanol-sensitive antibodies only; and HIV-infected subjects had significantly lower capsular polysaccharide-specific and VH3-positive antibody responses. These findings confirm decreased antibody responses to pneumococcal vaccination in HIV-infected persons and suggest that their poor responses may result from HIV-associated depletion of restricted B cell subsets.

(C) Copyright Oxford University Press 1998.