AEGiS-04CROI: Effect of zidovudine (ZDV) postexposure prophylaxis (PEP) on the development of HIV-specific cytotoxic T-lymphocyte (CTL) responses in HIV exposed health care workers (HCW).

4th Conference on Retroviruses and Opportunistic Infections

Washington, DC - January 22-26, 1997

Effect of zidovudine (ZDV) postexposure prophylaxis (PEP) on the development of HIV-specific cytotoxic T-lymphocyte (CTL) responses in HIV exposed health care workers (HCW).

Conf Retroviruses Opportunistic Infect 1997 Jan 22-26; 4th:70 (abstract no. 28)

Kessler HA, D'Amico R, Pinto LA, Meyer P, Berzofsky JA, Clerici M, Harris AA, Landay AL, Shearer GM; Rush Medical College, Chicago, IL.

Objectives: To assess the effect of PEP with ZDV on HIV specific CTL responses in HIV seronegative HCW parenterally exposed to HIV-infected blood.

Methods: HIV env-specific CTL activity of env-stimulated PBMC cultures was measured by a standard 6 hour (51)Cr release assay, using synthetic env-peptide pulsed autologous EBV transformed B cells as targets. Anti-HIV antibody was tested by EIA and HIV PCR by the Roche Molecular Systems method.

Results: Evaluation of exposures for factors associated with an increased risk of HIV transmission showed 3/20 HCW with a deep injury, 6/17 reported visible blood on the device, in 3/20 the device was used in a blood vessel, and 3/19 source patients died within 60 days of the exposure. 10/15 source patients had CD4 counts less than 50/ul. HIV env-specific CTL activity was observed in 7/20 (35%) HIV exposed HCW, 0/20 HCW exposed to HIV negative blood and 0/7 healthy blood donors. No HIV exposed HCW became infected. 7/20 HIV exposed HCW chose to take PEP with ZDV. Only 1/7 (14%) of these HCW developed an HIV-specific CTL response as compared to the development of CTL responses in 6/13 (46%) of the HCW who did not take ZDV. The estimated odds ratio for the effect of ZDV on the development of a CTL response was 0.3. Confidence intervals were very large due to a small data set.

Conclusions: These data suggest that ZDV used for PEP prevents HIV replication and HIV replication is necessary for the development of HIV-specific CTL responses. HIV-specific CTL responses may be useful as a surrogate marker of HIV replication in the evaluation of new regimens for PEP of accidental occupational HIV exposures.

Keywords: AEGIS, Zidovudine, T-Lymphocytes, Cytotoxic, Health Personnel, Anti-HIV Agents, CD4 Lymphocyte Count, HIV Antibodies, Occupational Exposure, Virus Replication, Human, prevention & control, virology, AIDS

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Copyright © 1980, 1997 - Foundation for Retrovirology and Human Health. Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Foundation for Retrovirology and Human Health. Licensed through AIDSLINE, National Library of Medicine.