TY - JOUR
T1 - Immune-correlates analysis of an HIV-1 vaccine efficacy trial
AU - Haynes, Barton F.
AU - Gilbert, Peter B.
AU - McElrath, M. Juliana
AU - Zolla-Pazner, Susan
AU - Tomaras, Georgia D.
AU - Alam, S. Munir
AU - Evans, David T.
AU - Montefiori, David C.
AU - Karnasuta, Chitraporn
AU - Sutthent, Ruengpueng
AU - Liao, Hua Xin
AU - DeVico, Anthony L.
AU - Lewis, George K.
AU - Williams, Constance
AU - Pinter, Abraham
AU - Fong, Youyi
AU - Janes, Holly
AU - DeCamp, Allan
AU - Huang, Yunda
AU - Rao, Mangala
AU - Billings, Erik
AU - Karasavvas, Nicos
AU - Robb, Merlin L.
AU - Ngauy, Viseth
AU - De Souza, Mark S.
AU - Paris, Robert
AU - Ferrari, Guido
AU - Bailer, Robert T.
AU - Soderberg, Kelly A.
AU - Andrews, Charla
AU - Berman, Phillip W.
AU - Frahm, Nicole
AU - De Rosa, Stephen C.
AU - Alpert, Michael D.
AU - Yates, Nicole L.
AU - Shen, Xiaoying
AU - Koup, Richard A.
AU - Pitisuttithum, Punnee
AU - Kaewkungwal, Jaranit
AU - Nitayaphan, Sorachai
AU - Rerks-Ngarm, Supachai
AU - Michael, Nelson L.
AU - Kim, Jerome H.
PY - 2012/4/5
Y1 - 2012/4/5
N2 - BACKGROUND: In the RV144 trial, the estimated efficacy of a vaccine regimen against human immunodeficiency virus type 1 (HIV-1) was 31.2%. We performed a case-control analysis to identify antibody and cellular immune correlates of infection risk. METHODS: In pilot studies conducted with RV144 blood samples, 17 antibody or cellular assays met prespecified criteria, of which 6 were chosen for primary analysis to determine the roles of T-cell, IgG antibody, and IgA antibody responses in the modulation of infection risk. Assays were performed on samples from 41 vaccinees who became infected and 205 uninfected vaccinees, obtained 2 weeks after final immunization, to evaluate whether immune-response variables predicted HIV-1 infection through 42 months of follow-up. RESULTS: Of six primary variables, two correlated significantly with infection risk: the binding of IgG antibodies to variable regions 1 and 2 (V1V2) of HIV-1 envelope proteins (Env) correlated inversely with the rate of HIV-1 infection (estimated odds ratio, 0.57 per 1-SD increase; P = 0.02; q = 0.08), and the binding of plasma IgA antibodies to Env correlated directly with the rate of infection (estimated odds ratio, 1.54 per 1-SD increase; P = 0.03; q = 0.08). Neither low levels of V1V2 antibodies nor high levels of Env-specific IgA antibodies were associated with higher rates of infection than were found in the placebo group. Secondary analyses suggested that Envspecific IgA antibodies may mitigate the effects of potentially protective antibodies. CONCLUSIONS:This immune-correlates study generated the hypotheses that V1V2 antibodies may have contributed to protection against HIV-1 infection, whereas high levels of Envspecific IgA antibodies may have mitigated the effects of protective antibodies. Vaccines that are designed to induce higher levels of V1V2 antibodies and lower levels of Env-specific IgA antibodies than are induced by the RV144 vaccine may have improved efficacy against HIV-1 infection.
AB - BACKGROUND: In the RV144 trial, the estimated efficacy of a vaccine regimen against human immunodeficiency virus type 1 (HIV-1) was 31.2%. We performed a case-control analysis to identify antibody and cellular immune correlates of infection risk. METHODS: In pilot studies conducted with RV144 blood samples, 17 antibody or cellular assays met prespecified criteria, of which 6 were chosen for primary analysis to determine the roles of T-cell, IgG antibody, and IgA antibody responses in the modulation of infection risk. Assays were performed on samples from 41 vaccinees who became infected and 205 uninfected vaccinees, obtained 2 weeks after final immunization, to evaluate whether immune-response variables predicted HIV-1 infection through 42 months of follow-up. RESULTS: Of six primary variables, two correlated significantly with infection risk: the binding of IgG antibodies to variable regions 1 and 2 (V1V2) of HIV-1 envelope proteins (Env) correlated inversely with the rate of HIV-1 infection (estimated odds ratio, 0.57 per 1-SD increase; P = 0.02; q = 0.08), and the binding of plasma IgA antibodies to Env correlated directly with the rate of infection (estimated odds ratio, 1.54 per 1-SD increase; P = 0.03; q = 0.08). Neither low levels of V1V2 antibodies nor high levels of Env-specific IgA antibodies were associated with higher rates of infection than were found in the placebo group. Secondary analyses suggested that Envspecific IgA antibodies may mitigate the effects of potentially protective antibodies. CONCLUSIONS:This immune-correlates study generated the hypotheses that V1V2 antibodies may have contributed to protection against HIV-1 infection, whereas high levels of Envspecific IgA antibodies may have mitigated the effects of protective antibodies. Vaccines that are designed to induce higher levels of V1V2 antibodies and lower levels of Env-specific IgA antibodies than are induced by the RV144 vaccine may have improved efficacy against HIV-1 infection.
UR - http://www.scopus.com/inward/record.url?scp=84859393693&partnerID=8YFLogxK
U2 - 10.1056/NEJMoa1113425
DO - 10.1056/NEJMoa1113425
M3 - Article
AN - SCOPUS:84859393693
SN - 0028-4793
VL - 366
SP - 1275
EP - 1286
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 14
ER -