Archive for July 16, 2013

IRIS – the unfortunate rainbow of HIV.

Blood. 2012 Mar 29;119(13):2971-2.

Chahroudi A, Silvestri G.


Emory University.


In this issue of Blood, Mahnke and colleagues identify polyfunctional CD4(+) T-cell responses directed against specific opportunistic pathogens in HIV-infected patients who develop immune reconstitution inflammatory syndrome (IRIS) after initiation of antiretroviral therapy (ART). This work provides a mechanistic advance to our understanding of IRIS pathogenesis.


July 16, 2013 at 2:32 pm

Síndrome de reconstitución inmune en pacientes con infección VIH. Estudio prospectivo de una serie de casos

Enf Infecc & Microbiol. Clínica Octubre 2006 V.24 N.8 P.536-537

Carta al Editor

Immune reconstitution in HIV-infected patients.A prospective analysis

Javier de la Torre-Lima, Alfonso del Arco-Jiménez, José Luis Prada-Pardal y Josefa Aguilar-García

Unidad de Medicina Interna. Área de Medicina. Hospital Costa del Sol. Marbella. Málaga. España.


July 16, 2013 at 2:31 pm

Immune Restoration Disease in HIV Patient

Emerging Infectious Diseases EID April 2006 V.12 N.4 P.689-691

Neil E. Jenkins,* Mike B.J. Beadsworth,* James J. Anson,* Fred J. Nye,* Vanessa J. Martlew,* and Nick J. Beeching*

Liverpool School of Tropical Medicine, Liverpool, United Kingdom

We describe a severely immunosuppressed HIV-1–positive man in whom immune restoration disease associated with pulmonary infection caused by Mycobacterium microti developed after antiretroviral treatment. The diagnosis was made by using convenient spoligotyping techniques, but invasive investigations were required to exclude a tumor


July 16, 2013 at 2:30 pm

Immune Reconstitution in HIV-Infected Patients

Clinical Infectious Disease April 15, 2004 V.38 N.8 P.1159-1166

Kenneth H. Mayer, Section Editor

Hans H. Hirsch1,2, Gilbert Kaufmann1, Pedram Sendi1,3, and Manuel Battegay1

1Division of Infectious Diseases, University Hospital Basel, Switzerland

2Institute for Medical Microbiology, University Hospital Basel, Switzerland

3Institute for Clinical Epidemiology, University Hospital Basel, Switzerland

Reprints or correspondence: Dr. Manuel Battegay, Div. of Infectious Diseases, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland (

The prognosis of patients infected with human immunodeficiency virus (HIV) type 1 has dramatically improved since the advent of potent antiretroviral therapies (ARTs), which have enabled sustained suppression of HIV replication and recovery of CD4 T cell counts. Knowledge of the function of CD4 T cells in immune reconstitution was derived from large clinical studies demonstrating that primary and secondary prophylaxis against infectious agents, such as Pneumocystis jirovecii (Pneumocystis carinii), Mycobacterium avium complex, cytomegalovirus, and other pathogens, can be discontinued safely once CD4 T cell counts have increased beyond pathogen-specific threshold levels (usually >200 CD4 T cells/mm3) for 3–6 months. The downside of immune reconstitution is an inflammatory syndrome occurring days to months after the start of ART, with outcomes ranging from minimal morbidity to fatal progression. This syndrome can be elicited by infectious and noninfectious antigens. Microbiologically, the possible pathogenic pathways involve recognition of antigens associated with ongoing infection or recognition of persisting antigens associated with past (nonreplicating) infection. Specific antimicrobial therapy, nonsteroidal anti-inflammatory drugs, and/or steroids for managing immune reconstitution syndrome should be considered.


July 16, 2013 at 2:29 pm

Local response to microneedle-based influenza immunization in the skin.

MBio. 2012 Mar 6;3(2):e00012-12.

del Pilar Martin M, Weldon WC, Zarnitsyn VG, Koutsonanos DG, Akbari H, Skountzou I, Jacob J, Prausnitz MR, Compans RW.


Department of Microbiology and Immunology, Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, USA.


Microneedle patches (MN) provide a novel method of vaccine delivery to the skin with the objective of targeting the large network of resident antigen-presenting cells to induce an efficient immune response. Our previous reports demonstrated that cutaneous delivery of inactivated influenza virus-coated MN to mice protects against lethal infection. Protection is correlated with sustained levels of anti-influenza virus serum antibodies, hemagglutination inhibition titers, and robust cellular responses that are often stronger than those generated by intramuscular vaccination. Here we dissect the early events occurring in murine skin after microneedle delivery of inactivated influenza virus. We demonstrate correlation of immunization against influenza virus with a local increase of cytokines important for recruitment of neutrophils, monocytes and dendritic cells at the site of immunization. We also observed prolonged antigen deposition, and migration of matured dendritic cells bearing influenza virus antigen from the skin.


The immunological mechanisms by which MN vaccination confers protective immunity are not well understood. The present study provides a first analysis of the early immune events after microneedle-based vaccination


July 16, 2013 at 2:28 pm

Current evidence on intradermal influenza vaccines administered by Soluvia™ licensed micro injection system.

Hum Vaccin Immunother. 2012 Jan;8(1):67-75.

Icardi G, Orsi A, Ceravolo A, Ansaldi F.


Department of Health Sciences, University of Genoa, Genoa, Italy.


Among the several strategies explored for (1) the enhancement of the immune response to influenza immunization, (2) the improvement of the vaccine acceptability and (3) the overcoming of the egg-dependency for vaccine production, intradermal administration of influenza vaccine emerges as a promising alternative to conventional intramuscular route, thanks to the recent availability of new delivery devices and the perception of advantages in terms of immunogenicity, safety, reduction of antigen content and acceptability. Data from clinical trials performed in children, adults < 60 y and elderly people and post-marketing surveillance demonstrate that actually, licensed intradermal influenza vaccines, Intanza™ 9 and 15 µg and Fluzone™ Intradermal, administered by the microinjection system Soluvia™, show an excellent acceptability, tolerability and safety profile. Formulations containing 9 and 15 μg per strain demonstrate, respectively, comparable and superior immunogenicity than conventional intramuscular vaccines. Licensed intradermal influenza vaccines can be considered a valid alternative to standard intramuscular vaccination offering significant advantages in low-responder populations and helping to increase influenza vaccination coverage rates especially in people with fear of needles or high apprehension associated with annual vaccination.


July 16, 2013 at 2:27 pm


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