A Phase I evaluation of the safety and immunogenicity of vaccination with recombinant gp160 in patients with early human immunodeficiency virus infection

Article Abstract:

The most effective weapon against viral diseases is immunization. It is not yet known, however, whether immunization will ultimately prove to be effective in the battle against AIDS. It is well established that patients infected with the AIDS virus (human immunodeficiency virus, HIV) develop antibodies against the virus, but these antibodies cannot prevent the ultimate progression of the disease. However, it may be possible to slow the progression of AIDS by assisting, with immunization, the production of antibodies in patients already infected with HIV. This possibility was evaluated in 30 subjects in the early stages of HIV infection. The patients were inoculated not with the AIDS virus, but with gp160. This protein is a part of the outer envelope of HIV; gp160 for inoculation purposes was prepared by cloning the gp160 gene and growing large quantities in the laboratory. The 30 subjects were divided into six groups; each group was vaccinated according to one of two schedules and at one of three different doses of vaccine. Measurements of the antibody response to gp160 showed that 19 of the 30 patients developed increased levels of antibodies in response to the immunization. A critical factor determining the response of the patient appears to be the stage of the disease. HIV-infected patients suffer a progressive loss of T cells with the CD4 antigen from their blood, and this loss serves as a useful measure of the progression of the infection. In the present study, 13 of the 16 subjects who still had more than 600 CD4 cells per milliliter of blood developed a successful antibody response, in contrast with 6 of the 14 subjects who had fewer than 600 CD4 cells per milliliter. It is too early to tell if the patients with a successful response to the gp160 vaccine will have a slower progression of disease. However, after 10 months the CD4 cell count has not decreased in the 19 patients who responded to immunization, while an average 7.3 percent decrease in the CD4 count was observed in the 11 subjects who did not respond. The results of this study indicate that the gp160 vaccine is safe and capable of eliciting an immune response in some HIV-infected patients. Furthermore, there is reason to suspect that the disease progression may be slower in the patients who responded successfully to immunization. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Prevention, Physiological aspects, Vaccines

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Human immunodeficiency virus infections in teenagers: seroprevalence among applicants for US military service

Article Abstract:

The prevalence of AIDS (acquired immunodeficiency syndrome) in teenagers living in the United States is at present relatively low. Of all AIDS cases reported, approximately 0.4 percent have been in persons aged 13 to 19 years old. However, AIDS represents only the advanced stage of human immunodeficiency virus (HIV) infection, and the number of HIV-infected teenagers in this country is not known. As a follow-up to a survey conducted in October 1985 which assessed the prevalence of HIV infection in the US military, a similar survey was conducted which focused on HIV-infected individuals under the age of 20 years. The results of blood tests that were performed on 1,141,164 teenagers who applied for entry into the military between October 15, 1985 and March 31, 1989 were examined. Of this number, 393 applicants tested positive for HIV infection, which represented about one in every 3,000 (0.34 per 1,000) applicants nationwide. No significant difference in the frequency of HIV positivity was noted between the sexes (0.35 per 1,000 in males compared with 0.32 per 1,000 in females). However, blacks tested positive for HIV infection significantly more frequently than whites or Hispanics, at 1.06 per 1,000 compared with 0.18 per 1,000 in whites and 0.31 per 1,000 in Hispanics. A marked difference in prevalence was observed by geographic area. In the north-central states, the incidence was less than 0.1 per 1,000, compared with greater than 2 per 1,000 in urban counties of New York, the District of Columbia, Maryland, and Texas. Although the applicants to the military may not be representative of all teenagers nationwide, the data provide a basis for estimating the prevalence of HIV infection by geographic area and demographic groups. It is concluded that HIV infection is a real and immediate threat to US teenagers and it is not uncommon in this population, despite the fact that thus far, there have been few AIDS cases reported. (Consumer Summary produced by Reliance Medical Information, Inc.)

Testing, Surveys, Recruiting, Armed Forces, Teenagers, Youth, AIDS virus carriers, HIV carriers

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HIV infection among members of the US Army Reserve components with medical and health occupations

Article Abstract:

HIV, or human immunodeficiency virus, causes AIDS and is transmitted by contact with body fluids such as blood. Because of the increased contact that health care workers have with such fluids, it is commonly considered that individuals in these professions are at increased risk for infection with HIV. The risk of occupationally transmitted HIV infection appears to be quite low, but precise estimates are not possible with the data currently available. To further characterize the extent to which health care workers are susceptible to increased rates of HIV infection, the records of over 58,000 members of the US Army Reserve with military or civilian health care professions were reviewed. Among women and currently married men, rates of HIV infection were similar; the rate of infection was not related to whether these individuals' had medical or nonmedical occupations. Among never-married men, the prevalence of HIV infection was increased among those with both military and civilian medical professions. When this finding was analyzed with respect to reported civilian profession, male nurses and other medical personnel, excluding physicians and dentists, were found to be at higher risk for HIV infection. Since the risk of infection among women reservists was the same regardless of occupation, occupational exposure should not be considered the only explanation for the increased prevalence of HIV infection among male health care workers. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Risk factors, Demographic aspects, Medical personnel, Work environment, Military personnel, HIV seropositivity, HIV positive, AIDS (Disease) in the workplace

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