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HIV-Positive Patients Show Varied T Cell Response to Orthopoxvirus Vaccination and Infection

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Recent research has uncovered critical insights into the immune responses of HIV-positive patients against orthopoxviruses, including mpox and smallpox. The study, conducted by a team of international researchers, offers valuable insight into how vaccination and natural infection can influence the body’s T cell response, a crucial component in fighting viral infections.

The findings were published in the journal Vaccines.

The research centred on the use of an ELISpot assay, a sophisticated method to measure T cell response, particularly focusing on IFN-γ or IL-2 secretion, vital components of the immune response. This approach allowed a detailed analysis of how HIV-positive patients’ immune systems react to orthopoxvirus vaccinations and infections.

The findings revealed that two-thirds of HIV-positive patients showed a significant T cell response following two doses of the smallpox vaccine. However, the response was even more pronounced in patients who had been naturally infected with mpox. In these cases, all patients showed a specific IFN-γ secretion, and 70% exhibited a specific IL-2 secretion, indicating a robust immune response.

Interestingly, the study also highlighted the varying degrees of immune response depending on the patient’s characteristics. For example, the age of the patient, the interval between vaccination and infection, and the counts of different T cell types (CD4+ and CD8+) were all factors that influenced the strength of the immune response. This finding is significant as it suggests that individual patient characteristics can play a crucial role in the effectiveness of vaccinations and the body’s ability to fight off infections.

A key aspect of the research was comparing the immune responses of HIV-positive patients with those of healthy controls. This comparison revealed that the immune responses in HIV-positive patients were at a similar level to those of healthy adults after a recent smallpox vaccination. However, the study also noted that a single smallpox vaccination in early childhood might not induce a detectable T cell response many years later.

The research’s implications are far-reaching, especially in light of the ongoing efforts to manage and prevent mpox infections worldwide. The study’s results suggest that while vaccination can induce a protective T cell response in a significant portion of HIV-positive patients, the response to natural infection is generally more robust. This understanding is crucial in developing strategies for vaccination and in managing mpox outbreaks, particularly among at-risk populations like HIV-positive individuals.

The study also sheds light on the potential long-term immunity offered by smallpox vaccinations. While a single vaccination in early childhood may not induce a lasting detectable response, the study suggests that adults vaccinated in childhood could exhibit milder symptoms or even no symptoms at all upon mpox infection, indicating some level of long-term immunity.

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