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Blood, 15 September 2004, Vol. 104, No. 6, pp. 1784-1792.
Prepublished online as a Blood First Edition Paper on June 8, 2004; DOI 10.1182/blood-2004-01-0251.


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Submitted January 27, 2004
Accepted April 20, 2004

Humoral immunity to HIV-1: Kinetics of antibody responses in chronic infection reflect capacity of immune system to improve viral set point

Alexandra Trkola*, Herbert Kuster, Christine Leemann, Annette Oxenius, Catherine Fagard, Hansjakob Furrer, Manuel Battegay, Pietro Vernazza, Enos Bernasconi, Rainer Weber, Bernard Hirschel, Sebastian Bonhoeffer, and Huldrych F Guenthard

Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
Institute for Microbiology, ETH Zentrum Zurich, Zurich, Switzerland
Division of Infectious Diseases, University Hospital Geneva, Geneva, Switzerland
Division of Infectious Diseases, Inselspital Bern, Bern, Switzerland
Division of Infectious Diseases, University Hospital Basel, Basel, Switzerland
Medizinische Klinik, University Hospital St Gallen, St Gallen, Switzerland
Division of Infectious Diseases, Ospedale Civico, Lugano, Switzerland
Institute of Ecology, ETH Zentrum Zurich, Zurich, Switzerland

* Corresponding author; email: alexandra.trkola{at}usz.ch.

We analyzed the humoral immune response in 46 patients following structured treatment interruption (STI) to investigate the general potential of therapeutic vaccination in chronic HIV-1 infection. Evoked antibody titer increases to gp120 and p24 were low during 4 short-term STIs and only reached significance during a 5th long-term interruption. Although induction of binding antibodies to viral antigens was not associated with potent suppression of viremia, we observed that individuals with a rapid and high response to p24, and to a lesser extent also to gp120, lowered their viral set points significantly. Of note, the increase of the anti-p24 response correlated with specific CD4 T helper frequency to this antigen. Despite induction of binding antibody responses, which correlated with improved viral control, the increase in neutralizing activity was marginal and did not lead to this enhanced viral suppression. However, a subgroup of patients who potently suppressed viremia independently of STI, had significantly higher pre-existing neutralization titers suggesting a role of humoral immunity in conferring potent protection. In summary, measuring the kinetics of antibody responses provided a marker to validate the responsiveness and capacities of the immune system of HIV-1 infected individuals and reflected the patients' ability to decrease viral set points.


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