HIV-specific T-helper activity in seronegative health care workers exposed to contaminated blood

M. Clerici, J. M. Levin, H. A. Kessler, A. Harris, J. A. Berzofsky, A. L. Landay and G. M. Shearer
National Cancer Institute, National Institutes of Health, Experimental Immunology Branch, Bethesda, MD 20892.

OBJECTIVE--To evaluate human immunodeficiency virus (HIV) type 1-specific cellular immune responses in HIV-seronegative health care workers with occupational high-risk exposures to HIV-infected (HIV-positive) patients. DESIGN--Peripheral blood mononuclear cells (PBMCs) were obtained after occupational exposures to HIV, and PBMCs from health care workers exposed to HIV-negative patients served as controls. The PBMCs were stimulated in vitro with HIV envelope synthetic peptides. Interleukin 2 (IL-2) production was measured in a bioassay. The HIV antibody status was determined by standard enzyme-linked immunosorbent assays. Exposed individuals were also evaluated for HIV proviral DNA by polymerase chain reaction techniques. PARTICIPANTS--The PBMCs from eight health care workers with high-risk exposures and nine control health care workers were studied. RESULTS--The PBMCs from all individuals showed strong IL-2 production to control antigens, indicating intact T-helper function. Interleukin 2 production to HIV peptides was detected in PBMCs from six of eight HIV-exposed individuals, but in only one of the nine health care workers exposed to HIV-negative body fluids (P < .008). None of the HIV-exposed health care workers became infected as determined by negative HIV antibody and polymerase chain reaction analysis after follow-up evaluation that ranged from 8 to 64 weeks. CONCLUSION--Human immunodeficiency virus-specific T-helper activity was detected in six (75%) of eight HIV-negative health care workers with exposure to HIV-positive body fluids. Potent HIV-specific T-helper activity was detectable 4 to 8 weeks after the exposure and was lost in individuals followed up for 8 to 64 weeks. Three health care workers remained responsive at 8, 19, and 24 weeks. Exposure to HIV without evidence of subsequent infection appears to result in activation of cellular immunity without activation of antibody production.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Human Immunodeficiency Virus (HIV) gag Antigen-Specific T-Helper and Granule-Dependent CD8 T-Cell Activities in Exposed but Uninfected Heterosexual Partners of HIV Type 1-Infected Individuals in North India
Pallikkuth et al.
CVI 2007;14:1196-1202.
ABSTRACT | FULL TEXT  

Low Maternal Viral Loads and Reduced Granulocyte-Macrophage Colony-Stimulating Factor Levels Characterize Exposed, Uninfected Infants Who Develop Protective Human Immunodeficiency Virus Type 1-Specific Responses
Schramm et al.
CVI 2007;14:348-354.
ABSTRACT | FULL TEXT  

Cellular Immune Responses in Seronegative Sexual Contacts of Acute Hepatitis C Patients
Kamal et al.
J. Virol. 2004;78:12252-12258.
ABSTRACT | FULL TEXT  

Chronic Immune Activation Associated with Chronic Helminthic and Human Immunodeficiency Virus Infections: Role of Hyporesponsiveness and Anergy
Borkow and Bentwich
Clin. Microbiol. Rev. 2004;17:1012-1030.
ABSTRACT | FULL TEXT  

Potent Neutralizing Serum Immunoglobulin A (IgA) in Human Immunodeficiency Virus Type 2-Exposed IgG-Seronegative Individuals
Lizeng et al.
J. Virol. 2004;78:7016-7022.
ABSTRACT | FULL TEXT  

Structures of HLA-A*1101 Complexed with Immunodominant Nonamer and Decamer HIV-1 Epitopes Clearly Reveal the Presence of a Middle, Secondary Anchor Residue
Li and Bouvier
J. Immunol. 2004;172:6175-6184.
ABSTRACT | FULL TEXT  

Persistence of Extraordinarily Low Levels of Genetically Homogeneous Human Immunodeficiency Virus Type 1 in Exposed Seronegative Individuals
Zhu et al.
J. Virol. 2003;77:6108-6116.
ABSTRACT | FULL TEXT  

Host Background Immunity and Human Immunodeficiency Virus Protective Vaccines, a Major Consideration for Vaccine Efficacy in Africa and in Developing Countries
Borkow and Bentwich
CVI 2002;9:505-507.
FULL TEXT  

HIV-1 transmission and acute HIV-1 infection
Hansasuta and Rowland-Jones
Br Med Bull 2001;58:109-127.
ABSTRACT | FULL TEXT  

Discordant cellular and humoral immune responses to cytomegalovirus infection in healthy blood donors: existence of a Th1-type dominant response
Zhu et al.
Int Immunol 2001;13:785-790.
ABSTRACT | FULL TEXT  

Identification and Antigenicity of Broadly Cross-Reactive and Conserved Human Immunodeficiency Virus Type 1-Derived Helper T-Lymphocyte Epitopes
Wilson et al.
J. Virol. 2001;75:4195-4207.
ABSTRACT | FULL TEXT  

Host Response to Cytomegalovirus Infection as a Determinant of Susceptibility to Coronary Artery Disease : Sex-Based Differences in Inflammation and Type of Immune Response
Zhu et al.
Circulation 2000;102:2491-2496.
ABSTRACT | FULL TEXT  

Risk and Management of Blood-Borne Infections in Health Care Workers
Beltrami et al.
Clin. Microbiol. Rev. 2000;13:385-407.
ABSTRACT | FULL TEXT  

Containment of Simian Immunodeficiency Virus Infection: Cellular Immune Responses and Protection from Rechallenge following Transient Postinoculation Antiretroviral Treatment
Lifson et al.
J. Virol. 2000;74:2584-2593.
ABSTRACT | FULL TEXT  

CCR5-Reactive Antibodies in Seronegative Partners of HIV-Seropositive Individuals Down-Modulate Surface CCR5 In Vivo and Neutralize the Infectivity of R5 Strains of HIV-1 In Vitro
Lopalco et al.
J. Immunol. 2000;164:3426-3433.
ABSTRACT | FULL TEXT  

Effective Induction of Simian Immunodeficiency Virus-Specific Cytotoxic T Lymphocytes in Macaques by Using a Multiepitope Gene and DNA Prime-Modified Vaccinia Virus Ankara Boost Vaccination Regimen
Hanke et al.
J. Virol. 1999;73:7524-7532.
ABSTRACT | FULL TEXT  

Urine Antibody Tests: New Insights into the Dynamics of HIV-1 Infection
Urnovitz et al.
Clin. Chem. 1999;45:1602-1613.
ABSTRACT | FULL TEXT  

Postexposure Chemoprophylaxis for Occupational Exposures to the Human Immunodeficiency Virus
Henderson
JAMA 1999;281:931-936.
FULL TEXT  

Identification of a Conserved Universal Th Epitope in HIV-1 Reverse Transcriptase That Is Processed and Presented to HIV-Specific CD4+ T Cells by at Least Four Unrelated HLA-DR Molecules
van der Burg et al.
J. Immunol. 1999;162:152-160.
ABSTRACT | FULL TEXT  

Science, medicine, and the future: Infection with HIV-1
Graham
BMJ 1998;317:1297-1301.
FULL TEXT  

Genetic Evaluation of Suspected Cases of Transient HIV-1 Infection of Infants
Frenkel et al.
Science 1998;280:1073-1077.
ABSTRACT | FULL TEXT  

Anticipated Outcomes of Accidental Occupational Exposure to HIV
Meisenhelder
Clin Nurs Res 1997;6:291-299.
ABSTRACT  

Postexposure Treatment of People Exposed to the Human Immunodeficiency Virus through Sexual Contact or Injection-Drug Use
Katz and Gerberding
NEJM 1997;336:1097-1100.
FULL TEXT  

Protective immunity to HIV-1 in SCID/beige mice reconstituted with peripheral blood lymphocytes of exposed but uninfected individuals
Zhang et al.
Proc. Natl. Acad. Sci. USA 1996;93:14720-14725.
ABSTRACT | FULL TEXT  

Clearance of HIV -- Lessons from Newborns
McIntosh and Burchett
NEJM 1995;332:883-884.
FULL TEXT  

Management of Occupational Exposures to Blood-Borne Viruses
Gerberding
NEJM 1995;332:444-451.
FULL TEXT  

Reduction in CD8+ cell noncytotoxic anti-HIV activity in individuals receiving highly active antiretroviral therapy during primary infection
Stranford et al.
Proc. Natl. Acad. Sci. USA 2001;98:597-602.
ABSTRACT | FULL TEXT